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Annual report Interagency Council on Long-Term Care

Annual report Interagency Council on Long-Term Care 2007

ARIZONA
INTERAGENCY COUNCIL ON
LONG- TERM CARE
2007 ANNUAL REPORT
Prepared by:
Interagency Council on Long- Term Care
November 15, 2007
Equal Opportunity Employer/ Program
This document is available in alternative formats by contacting
The DES ADA Coordinator at 602.542.6572 Interagency Council on Long- Term Care
2007 Annual Report
I. Background
In 2001, the Legislature passed Senate Bill 1196 and created the Interagency Council on Long- Term Care ( Interagency Council). Pursuant to A. R. S. § 41- 4102, the purpose of the Interagency Council is " to help the state achieve a coordinated long- term care services delivery system." Additionally, the Interagency Council is required to " define this state's long- term care obligations by coordinating applicable state and federal mandates that relate to long- term care services." This report is prepared pursuant to A. R. S. § 41- 4102( C).
II.
Council Operating Guidance
Council Vision Statement
The Long- Term Care System in Arizona will be a family- friendly continuum of services that is person- centered involving seamless partnerships of the medical, social, physical, and mental health communities.
Council Mission Statement
Improve the quality of life for Arizona residents through a coordinated long- term care delivery system.
Council Purpose
The purpose of the Interagency Council is to help the state achieve a coordinated long- term care services delivery system. Additionally, the Interagency Council is required to define this state’s long- term care services including quality of care issues, access to services, and coordination/ integration of those services.
III.
Membership
Arizona Revised Statute § 41- 4101( A) mandates the Interagency Council's representation be the directors or the designees of the following departments:
• Department of Health Services ( DHS)
• Department of Economic Security ( DES)
• Arizona Health Care Cost Containment System ( AHCCCS)
• Department of Commerce ( DOC)
• Department of Insurance ( DOI)
The following individual representation was made as appointments:
• Executive Director of the Governor's Advisory Council on Aging
• Executive Director of the Governor's Council on Developmental Disabilities
• State Long- Term Care Ombudsman
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In addition, the following additional representation was made as three year appointments:
• One representative from an Agency on Aging in an urban area
• One representative from an Agency on Aging in a rural area
• Two members of the House of Representatives ( nonvoting)
• Two members of the Senate ( nonvoting)
Appointments to the Interagency Council are for three- year terms. A roster of the current appointments is attached as Appendix A.
IV.
Meeting Dates
The Interagency Council on Long- Term Care ( Council) is required to meet four times a year according to statute. The Council met on the following dates:
January 3, 2007 – Strategic Planning meeting
February 7, 2007
April 4, 2007
July 11, 2007
September 5, 2007
October 6, 2007
The Council’s January meeting was a strategic planning meeting devoted to identifying Gap Areas within the long- term care system and Agency Activities for the Council. It was the Council’s intent to entertain presentations on Gap Areas and Agency Activities at each of its 2007 meetings. Gap Areas were defined as areas where more work needed to be done and the Council’s membership could consider additional strategies to address the needs. Agency Activities were defined as new programs or initiatives that Council members were unaware of and could benefit from learning more about. The attached meeting minutes ( Appendix B) describe presentations made to the Council.
Gap Areas
􀂃
How to better give people information about the long- term care system and its options
􀂃
How to better integrate Adult Protective Services into the long- term care system
􀂃
Education of healthcare professionals
􀂃
Nutrition and hydration of long- term care recipients
􀂃
Impact of “ Choices” on home and community based services
􀂃
Lifespan respite care federal legislation, and the need for a statewide coalition for information and coordination
􀂃
Utilizing retired physicians and other healthcare workers, i. e., dentists
􀂃
Older Americans Act caregiver language – caregivers of adult children
Page 3
Agency Activities
􀂃
Long- Term Care Insurance
􀂃
New Ombudsman training
􀂃
Dental coverage
􀂃
Falls prevention initiative
􀂃
Department of Insurance information on liability insurers
􀂃
Department of Economic Security Division of Developmental Disabilities senior- focused unit
􀂃
Consumer to consumer quality evaluation of services
􀂃
Better education of physicians
􀂃
Education practioners and workers with disabilities
􀂃
Consumer directed care
􀂃
Transitional services – 1 time only
􀂃
Putting information on nursing home and assisted home performance on web
􀂃
Spouses as paid caregivers
􀂃
Consumer cooperatives
􀂃
Mature Workforce Imitative
􀂃
Aging 2020 Plan
V.
Council Projects
The Council assumed responsibility for oversight of two major cross- agency, long- tem care system coordination projects a year ago. The Council has established working committees to manage both these projects.
AZ Links: the Aging and Disability Resource Center project.
In September of 2005, the DES Division of Aging & Adult Services ( DAAS) was notified by the federal Administration on Aging that it had been awarded an Aging and Disability Resource Center ( ADRC) grant for $ 750,000 over three years. DES/ DAAS is partnering with AHCCCS, the Governor’s Council on Aging, the Governor’s Council on Developmental Disabilities, DES/ Division of Developmental Disabilities, Area Agencies on Aging, the Arizona Bridge to Independent Living, community aging and disability groups, and the University of Arizona in working toward creating a single, coordinated system of information, assistance, and access for all persons seeking long- term care ( LTC) services. In Arizona, this effort is known as the AZ Links Project.
Information about and access to LTC services must be available to all of Arizona’s citizens to plan for and make informed decisions about their future needs in the most cost effective manner while choosing from a panoply of options that promote choice, independence and dignity. Persons seeking services from the state and its contractors need to have a system that allows them to proceed from information and referral to eligibility application and determination to service acquisition, and finally, to service coordination. To accomplish these goals, the state is working toward developing a comprehensive, seamless information, referral, and eligibility system along with the necessary data
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management infrastructure. A committee of the Interagency Council on Long- Term Care will serve as the advisory committee to this grant project.
AZ Links is being rolled out using two strategies:
Regional Collaboratives
Collaboratives consisting of staff from area agencies on aging, DES Division of Developmental Disabilities, independent living centers, and Arizona Health Care Cost Containment System ( AHCCCS) have been formed in Mohave and Maricopa counties. Members are focusing on cross- training within the system and common assessment and referral protocols to provide a “ no wrong door” for clients.
AZ Links Website
A beginning static website with pages of information and useful links went live on August 1, 2007 with the URL of www. azlinks. gov. Future plans for the site include the opportunity for consumers to establish their own accounts and for the site to have a common assessment, intake, and referral capability.
The Direct Care Workforce Training effort.
In April 2005, the Citizens Workgroup on the Long- Term Care Workforce issued their recommendations to Governor Napolitano in a report titled, “ Will Anyone Care? Leading the Paradigm Shift in Developing Arizona’s Direct Care Workforce.” The report offered 10 recommendations to improve the direct care workforce capacity and supply:
1.
State agencies must establish and implement policies to support informal/ family caregivers to ensure that the demand for professional caregivers does not outweigh supply and thus exacerbate the financial challenge already facing an overburdened system.
2.
State agencies responsible for regulating oversight of direct care workers must develop a standardized, uniform, and universal training curriculum.
3.
Plans developed by state agencies that serve elders and people with disabilities should be modeled on the concept of person- centered care.
4.
One state agency should be identified as the focal point for resource development for health care workforce initiatives, and designated to play a proactive role in seeking state, federal, and private grants to further develop Arizona’s direct care workforce.
5.
State policy must require and fund health insurance and benefits for direct care workers in long term care settings.
6.
Public and private sector employers must fundamentally re- evaluate the wages paid to the direct care workforce and balance this with the value of the services they provide.
7.
Funding for pilot projects to enhance direct care workforce recruitment and retention in long term care should be identified.
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8.
The state should mount a public awareness campaign to promote the image and profile of the direct care workforce.
9.
The state should continue to support and develop preventative health care programs.
10.
Support the incorporation of long- term care workers into existing professional associations, or the creation of an association dedicated to the direct care worker in the long- term care setting.
The Citizens Workgroup on the Long- Term Care Workforce, Education and Training subcommittee developed a training curriculum to provide the basis for a standardized, universal, and uniform training. The core curriculum is 30 hours and includes the following competencies: client’s rights/ dignity, basics of documentation, HIPPA/ confidentiality, stress and time management, basic principles of personal care, lifting, assistive devices, nutrition, and health and safety. The core curriculum was piloted in June 2005 at Phoenix College. An aging and physical disabilities module and developmental disabilities module were reviewed by the curriculum development committee at Phoenix College, and course competencies were established for the Maricopa County Community College System. There are plans to pilot the core and two modules at Phoenix College in the fall of 2007. Pima Community College offered two courses in the summer of 2007 and is planning two additional courses in the fall of 2007.
Building on the activities of the Citizens Workgroup on the LTC Workforce, the Council has established a committee to direct the long- term care workforce effort. As a result of Council discussion, DES, AHCCCS, and ADHS have come together to jointly fund a Direct Care Workforce Specialist position within the DES/ DAAS to assist the subcommittee in the project’s management, to serve as a resource for direct care workforce initiatives, and to further develop Arizona’s direct care workforce.
DES/ DAAS has directed $ 100,000 to train direct support professionals in Maricopa, Pinal, and Pima counties using the standardized training curriculum through the Maricopa and Pima Community College systems. As a result of a Committee strategic planning meeting held on May 24th, other project directions for the current year include: ( 1) The direct care worker training process should initially focus on employees of state- funded agencies providing in- home services. This should include both new and existing employees. ( 2) A subcommittee should prepare a recommendation for the parameters of the training program, including tiers of certification and a timeframe. ( 3) A subcommittee should pursue the discussion of delivery methods and instruments for the assessment of theoretical and practical knowledge.
Completed Project Activities
1.
The Maricopa County Area Agency on Aging sent an invitation for participation on January 22, 2007, to providers. It briefly described the project and announced the training sessions for trainers.
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2.
The training manuals for the Core, the Aging & Physical Disabilities, and the Developmental Disabilities module were completed and printed by DES. Toolkits with teaching materials and DVDs were assembled for all three classes. Master trainers are:
Core: Susan Kilby ( FSL) and Diane Patton ( ABIL)
E/ PD: Susan Kilby ( FSL) and Diane Patton ( ABIL)
DD: Wendy Ketterer ( AIRES)
3.
The two trainings were conducted as planned in February and April. Forty- one individuals attended the Core and one ( or both) of the two modules.
􀂃
Trained instructors/ representatives of agencies: Core 41
􀂃
Trained instructors/ representatives of agencies: Aging/ PD 26
􀂃
Trained instructors/ representatives of agencies: DD 27
􀂃
Agencies represented: 27
􀂃
Agencies agreeing to test the curriculum ( or selections): 20
􀂃
Agencies that signed an agreement to train 10 direct care and support professionals, ideally by June 30, 2007, received a toolkit.
4.
Two instructors from Pima Health System attended the training in Phoenix and will work with Pima Community College in Tucson to offer classes for direct care and support professionals. The first class started May 12, 2007. Over 30 individuals had signed up and 13 completed the course. Twenty- two students completed the second class in July 2007. The college offers a certificate and college credits to participants; tuition is paid from the funds made available by DES to the Pima Council on Aging.
5.
CJ O’Connor of the Maricopa County Area Agency on Aging has developed a plan for the evaluation of the project. She conducted telephone interviews with participants of the February session, and she has developed questionnaires for trainers and the direct care and support professionals receiving the training.
Plans for the Future
1. Pima Community College is planning to offer two additional courses in the fall of 2007. The college is also planning the development of a hybrid course. The training project is expanding to Pinal/ Gila region, with Pinal/ Gila Council for Seniors exploring implementation in rural areas. In Maricopa, three provider agencies will offer training through Phoenix College.
2. Project leaders and DES staff will follow up with the agencies that attended the trainings to promote the use of the curriculum in their training.
3. Through follow- up activities and formal evaluations, the acceptance of the curriculum and details regarding implementation will be assessed.
4. Project leaders and DES staff will work with the Core Curriculum and Expansion Committee to develop suggestions for further implementation and revisions.
5. Work continues on the Alzheimer’s Disease and Dementia module, and there are plans for a module on behavioral health.
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Executive Order 2007- 01 on Ensuring Quality in Long Term Care
The Governor established an Executive Order to address quality in long term care. The Departments of Health Service, Economic Security, and AHCCCS and the Governor’s Interagency Council on Long- Term Care were specified to play key roles in implementing the Order. The Executive Order specified a set of eleven Objectives for the next three years:
Objective 1: DHS, DES, and AHCCCS shall develop a comprehensive three- year strategy to improve quality in long term care, including focusing on nursing homes in the first year, assisted living in the second year, and community care in the third year.
Objective 2: DHS, AHCCCS, and DES, in collaboration with program contractors and the long term care industry, shall set goals and take measures to reduce Arizona's rates of pressure ulcers and restraint use in nursing homes, with a minimum goal of achieving and/ or sustaining rates well below the national average.
Objective 3: AHCCCS, DHS, and DES shall work together with the Arizona Long Term Care System program contractors to address and correct quality of care deficiencies in long term care facilities.
Objective 4: Beginning in FY08, and as permitted by law, DHS shall develop incentives for nursing homes that have achieved top quality care, based on criteria
set by the department and as measured and verified through the annual survey and quality rating processes.
Objective 5: DHS, AHCCCS, and DES shall enter into intergovernmental service agreements, using existing resources, to jointly staff a full- time position within the DES Division of Aging and Adult Services to work with community advocates, long term care providers, community colleges and other entities as deemed necessary to address the shortage of long term care direct care support professionals in Arizona.
Objective 6: DHS shall continue to take the lead in holding conferences to educate direct care staff about how to prevent pressure ulcers and properly use restraints, with the next such conference to occur before the end of 2007.
Objective 7: DHS shall post Quality Ratings of individual nursing homes on the department's website by no later than July 2007.
Objective 8: DHS shall post regulatory surveys for nursing homes and assisted living facilities on its website to provide consumers with quality information about assisted living facilities beginning no later than January 2008.
Objective 9: DHS, AHCCCS, and DES shall collaborate to develop a Consumer's Long Term Care Toolkit to provide Arizona families with the information, resources and guidance needed to make informed decisions about long term care.
Objective 10: DHS, during its survey process of nursing homes and assisted living facilities, shall foster better understanding and compliance with federal law regarding the provision and appropriate explanation of the Residents' Bill of Rights to all residents.
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Objective 11: By July 2009, the Interagency Council on Long Term Care is requested to recommend a Bill of Rights for consumers of home and community- based long term care services.
VI.
Listening Session
Pursuant to § A. R. S. 41- 3901( D), the Interagency Council must hold a public meeting to solicit comments on ways to improve Arizona’s Long- Term Care delivery system from the community so that it:
•
Ensures the dignity of consumers;
•
Meets the individual needs of consumers;
•
Provides high quality programs and services;
•
Provides an opportunity for consumers to choose and have input in their services;
•
Enhances home and community- based care;
•
Integrates funding sources to provide affordable services; and
•
Coordinates state and federal mandates.
Every two years, the Governor’s Advisory Council on Aging sponsors Senior Action Day at the Legislature. Traditionally this was an event on the Capitol lawns where seniors gathered for an opportunity to meet with their legislators and have some fun. Unfortunately, that also meant that a lot of people didn’t participate, because they could not or would not drive to Phoenix. So this past year the Council decided to try something different --- LOCAL Senior Action Days!
This past spring, the Council held a local Senior Action Day event in seven communities across Arizona. The first event of the day was a luncheon for legislators and concerned seniors from their respective legislative districts. The luncheons were designed to allow legislators to participate and learn more about the issues that affect older Arizonans and the role they can play in helping us all remain in our own homes and communities throughout our lives.
Following the luncheons, public hearings were convened on- site to review the State Plan on Aging. The hearings were 1 ½ hours long. The public hearings were facilitated and generally were introduced by the host city Mayor and the legislators who stayed over from the luncheon. Five of the Plan’s eight Goals were covered and the main initiatives planned for each Goal. Written and verbal input was then solicited for each Goal.
The Chair of the Interagency on Long- Term Care participated in each of the public hearings. The broad scope of the State Plan on Aging allowed for consumer input across the breath of the long term care continuum. Given the extensive input received from these seven hearings across the state, they served as the Council’s listening session for 2007.
Below is a listing of dates and locations of the Senior Action Days.
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SENIOR ACTION DAYS - 2007
Date: Area & Districts/ Event Location
February 23rd Includes East Valley ( Maricopa) and Pinal districts of 8, 17, 18, 19, 20, 21, 22, & 23. Event held in Mesa at East Valley Senior Services Center.
March 16th Includes Mohave, La Paz, Yuma counties, districts 3 & 24. Event held in Parker at the Parker Senior Center.
March 23rd Includes North Phoenix, Paradise Valley, Scottsdale, Cave Creek/ Carefree districts of 6, 7, 8, 10, & 11. Event in Paradise Valley Senior Center.
March 30th Includes Central Phoenix, West Valley & Pinal districts of 9, 12, 13, 14, 15, 16, & 23. Event held in Avondale.
April 13th Includes upper northwest valley, Yavapai, & Coconino County districts of 1, 2, & 4. Event held at the Prescott Community Center.
April 20th Eastern & NE Arizona ( Coconino, Apache, Gila, Graham, Navajo counties), including districts 2 & 5. Event held in Globe, at the Globe City Hall.
April 27th Tucson and Southern AZ, ( Pima, Cochise, Santa Cruz, Greenlee counties) including districts 25, 26, 27, 28, 29, 30. Event held in Tucson at a senior center.
VII.
Next Steps
The Council will devote one of its first meetings in 2008 to a planning session to determine priority projects, in addition to the AZ Links Project and Direct Care Worker Training, with which the Council wants to become more involved. The Council will also continue to remain involved in the critical projects mentioned above to further the coordination, collaboration and improvement of Arizona’s Long Term Care System.
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APPENDIX A
INTERAGENCY COUNCIL ON LONG- TERM CARE MEMBER ROSTER
Page 11
2008 Interagency Council on Long- Term Care Roster Ms. Tracy Wareing, Director Ms. Jan Lesher, Director Department of Economic Security Department of Commerce Mr. Rex Critchfield, LTC Chair and Assistant Mr. Jerry Ewing, Assistant Deputy Director Department Director, DES Division of Aging & Adult Services of Commerce 1789 W. Jefferson, 2nd Flr., SE, Site Code 001A 1700 W. Washington, Executive Tower, Suite 600 Phoenix, AZ 85007 Phoenix, AZ 85007 ( 602) 542- 6572, Fax ( 602) 364- 0743 ( 602) 771- 1176 or ( 602) 771- 1100 ( main receptionist) TWareing@ azdes. gov JanL@ azcommerce. com RCritchfield@ azdes. gov JerryE@ azcommerce. com Ms. Susan Gerard, Director Ms. Mary Lynn Kasunic Department of Health Services President & CEO/ Area Agency Director Ms. Mary Wiley, LTC Vice Chair and Assistant Area Agency on Aging, Region One, Inc. Director, DHS Division of Assurance and Licensure 1366 East Thomas Road, Suite 108 150 N. 18th Avenue, Suite 510 Phoenix, Arizona 85014 Phoenix, AZ 85007 ( 602) 264- 2255, Fax ( 602) 230- 9132 ( 602) 364- 3064, Fax ( 602) 364- 4808 kasunic@ msn. com Gerards@ azdhs. gov Wileym@ azdhs. gov The Honorable Carolyn S. Allen Ms. Greta Mang, Elder Rights Specialist Arizona State Senate DES Division of Aging and Adult Services 1700 W. Washington, Room 303 1789 W. Jefferson, Site Code 950A Phoenix, AZ 85007 Phoenix, AZ 85007 ( 602) 926- 4480, Fax ( 602) 417- 3155 ( 602) 542- 6440, Fax ( 602) 542- 6575 callen@ azleg. gov gmang@ azdes. gov The Honorable Meg Burton Cahill Mr. Anthony D. Rodgers, Director Arizona State Senate Arizona Health Care Cost Containment System 1700 West Washington Mr. Alan Schafer, ALTCS Manager, OMC Phoenix, AZ 85007 701 East Jefferson MD 6100 ( 602) 926- 4124, Fax ( 602) 417- 3017 Phoenix, AZ 85034 mburtoncahill@ azleg. gov ( 602) 417- 4614 Anthony. Rodgers@ azahcccs. gov Alan. Schafer@ azahcccs. gov The Honorable Bob Stump Mr. Franc Kahn, Executive Director Arizona House of Representatives Governor’s Council on Developmental Disabilities 1700 West Washington, Room 344 3839 North Third St, Suite 306, Site Code 074Z Phoenix, AZ 85007 Phoenix, AZ 85012 ( 602) 926- 5413, Fax 417- 3109 ( 602) 277- 4986, FAX ( 602) 277- 4454 bstump@ azleg. gov fkahn@ azdes. gov The Honorable Barbara McGuire Ms. Melanie Starns, Executive Director Arizona House of Representatives Governor’s Advisory Council on Aging 1700 W. Washington 1700 W. Washington St., Suite 240 Phoenix, AZ 85007 Phoenix, AZ 85007 ( 602) 926- 3012, Fax ( 602) 417- 3123 ( 602) 542- 4710 bmcguire@ azleg. gov mstarns@ az. gov Ms. Jill Harrison, Director Ms. Christina Urias, Director Area Agency on Aging, Region IV Department of Insurance Western AZ Council of Governments ( WACOG) Erin Klug, Special Assistant to the Director 224 S. 3rd Avenue 2910 N. 44th Street, Ste. 210 Yuma, Arizona 85364 Phoenix, AZ 85018- 7256 ( 928) 782- 1886, Fax ( 928) 329- 4248 ( 602) 364- 2186 Jillh@ wacog. com curias@ azinsurance. gov jharrisonwacog@ yahoo. com eklug@ azinsurance. gov mbutterfield@ azinsurance. gov 11/ 01/ 07/ pat
APPENDIX B
INTERAGENCY COUNCIL ON LONG- TERM CARE MEETING MINUTES
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Interagency Council on Long Term Care ( IACLTC)
Planning Meeting Minutes
January 3, 2007
Committee Chair Rex Critchfield called the meeting to order at 1: 40 p. m. Quorum was established. Rex announced Bob York, Assistant Director for the DES Division of Aging and Adult Services, had tendered his resignation. Rex was assuming the Acting Assistant Director’s position.
Rex welcomed everyone and asked for introductions. Council members present were Rex Critchfield, Mary Wiley, Kathleen Heard, Karen Duffy, Marian Lupu, Robert Nixon, Alan Schafer, Jami Snyder, Sue Gerard and Melanie Starns.
Public in attendance were Leona Goldfarb, Angela Arens, Kathleen Pagels, Dick White, Karla Avery, Kim Simmons, Robin Jordan, Lynn Larson, Allie Masters, Randy Scott and Pat Talcott.
Chair Rex Critchfield began the meeting with discussion of AZ Links Project. He stated that the morning’s Steering Committee had decided upon a regional collaborative approach where multiple agencies will work together to assist individuals and families through the long term care system. The AZ Links Project Manager will assist agencies in Maricopa and Mohave counties to formulate regional collaborations. Rex stated there is nothing for the Council to approve today and there would be more to share at the next meeting in March.
Vice- Chair Mary Wiley provided the purpose of today’s meeting along with the background of the Council, a review of the Council’s authorizing legislation, and a review of the Council’s vision, mission, and purpose statement.
Vice- Chair Mary Wiley summarized the background of the Council’s beginnings from 6- 7 years ago, which grew from a grievous episode in a nursing home and the death of a woman from a severe sunburn in a nursing home. Sue Gerard brought numerous individuals together to determine what could be done with the long- term care system, including legislation, and thus the IACLTC came into being. Vice- Chair Mary Wiley reviewed the seven legislative intents for the Council, its Vision, Mission Statement, and Purpose.
Mary stated the 7 legislative points:
1.
Ensures the dignity of consumers of long- term care services.
2.
Is designed to meet the individual needs of consumers.
3.
Provides services and programs that are of the highest quality.
4.
Promotes consumer self- determination by providing an opportunity for consumer choice and input.
5.
Enhances appropriate alternatives to institutional care such as home and community based long- term care services.
1
6.
Integrates various funding sources to provide affordable services at the highest quality.
7.
Coordinates applicable state and federal mandates that relate to long- term care services.
Mary proceeded to read the Council Vision Statement, which the Council changed to reflect the changing of “ mental” health to “ behavioral” health.
The Council Mission Statement was changed to add, “ this entity was designed to be a high level dialog vehicle for state policy makers to ensure coordination and to prevent duplication of resources”.
Rex stated the Council has two standing sub- committees, AZ Links Committee and the Direct Workforce Committee, which report to the Council and they are important when looking at planning activities for the year. The three committees spoke about their future plans and matched their plans to the Council’s seven legislative intents.
The Council, with public participation, identified initiatives for 2007 that will address each of the Council’s seven legislative intents by its two standing committees, by the State Committee for the Reduction of Pressure Ulcers and Restraints ( SCRPUR), and then initiatives for each of the member agencies.
1.
Ensures the dignity of consumers of long- term services.
Committee Plans
-
Direct Care Worker ( DCW) delivery of standardized curriculum
-
Statewide Coalition on Restraints and Pressure Ulcer Reduction ( SCRPUR) activities
2.
Is designed to meet the individual needs of consumers.
Committee Plans
-
AZ Links website
-
AZ Links Uniform Assessment Instrument ( UAI)
-
SCRPUR activities
Agency Activities
-
Long Term Care Insurance ( AHCCCS)
-
New Ombudsman training – ( DAAS- DES)
-
Dental coverage - GCDD
-
Falls prevention initiative – GACA
Gap Areas
-
How to better give people information/ respond
-
How to better integrate Adult Protective Services into the LTC system
2
3.
Provides services and programs that are of the highest quality
Committee Plans
-
AZ Links website
-
DCW delivery of standardized curriculum
-
SCRPUR activities
Agency Activities
-
Department of Insurance information on liability insurers
-
New Ombudsman training ( DAAS- DES)
-
DDD senior- focused unit
-
Consumer to consumer quality evaluation of services ( DDD)
-
Better education of physician ( UofA)
Gap Areas
-
Education of healthcare professionals
-
Nutrition & hydration of LTC recipients
4.
Promotes consumer self- determination by providing an opportunity for consumer choice and input.
Committee Plans
-
AZ Links website
-
AZ Links outreach and education
-
SCRPUR activities
Agency Activities
-
Education practioners re: disabled workers ( AHCCCS)
-
Consumer directed care ( AHCCCS, EPD)
-
Spouses as paid caregiver ( AHCCS)
-
Transitional services – 1 time only ( AHCCS)
-
Putting information on nursing home and assisted living home performance on web
-
Consumer cooperatives ( DDD)
-
Mature Workforce Initiative ( GACA)
Gap Areas
-
Impact of “ Choices” on Home & Community Based Services
3
5.
Enhances appropriate alternatives to institutional care such as home and community based long- term care services.
Committee Plans
-
AZ Links website
-
AZ Links outreach and education
-
DCW delivery of standardized curriculum
-
DCW staff to coordinate and explore incentives (“ operationalizing curriculum”)
-
SCRPUR activities
Gap Areas
-
Lifespan respite care federal legislation, need a statewide coalition for information and coordination.
6.
Integrates various funding sources to provide affordable services at the highest quality.
Committee Plans
-
DCW exploring/ coordinating incentives, resources, and more affordable services.
Gap Areas
-
Utilizing retired physicians and other health care workers, i. e., dentists.
7.
Coordinates applicable state and federal mandates that relate to long- term care services.
Committee Plans
-
AZ Links regional collaborations
-
AZ Links UAI
-
DCW – hiring jointly funded position
-
SCRPUR activities
Agency Activities
-
Aging 2020 Plan
Gap Areas
-
Older Americans’ Act Caregiver language – caregivers of adult children
Discussion was exchanged that the Council needed more legislative and agency director participation. This topic will be an agenda item at a future meeting.
It was agreed the Council would meet next month on February 7th. The meeting was adjourned at 3: 55 p. m.
4
1
Interagency Council on Long Term Care ( IACLTC)
Meeting Minutes
February 7, 2007
Committee Chair Rex Critchfield called the meeting to order at 1: 36 p. m. Quorum was established.
A.
Welcome and Introductions
Committee Members Present: Mary Wiley, Kathleen Heard, Marian Lupu, Melanie Starns, Uta Brotherton, Jami Snyder, Robert Nixon,
Public in Attendance: Kathleen Pagels, Angela Arens, Lynn Larson, Robin Jordan, Dick White, Karla Averill, Kim Simmons, Robin Coulon and Pat Talcott.
B.
Approval of Minutes
Meeting minutes from January 3, 2007 were approved as submitted.
C.
AZ Links Project Update
Robin Jordan stated there were two meetings scheduled for the regional collaboratives on February 9th for Mohave County and February 13th for Maricopa County. Work is moving forward on the IT Charter Agreement with AHCCCS and a meeting was held with DES IT to start building the content for the website.
D.
Direct Care Work Committee Update
Jami Snyder stated they are working on the first round of training here in Maricopa County on the Disability Module. Many providers are interested in having their employees take the training. Lynn Larson is contacting Ted Rausch at Pima College regarding the manuals. Curriculum for Pima College could be approved at the College Committee’s March meeting. Jami stated they are working with the local Area Agency to evaluate the training programs.
E. Review of the Executive Order 2007- 01 on Ensuring Quality In Long- Term Care Melanie Starns distributed a copy of the executive order issued January 2006 by the Governor. The purpose of this order is to focus on ensuring quality in long- term care through strategies in a 3- year Plan. Item # 11 of the Executive Order asked the IACLTC to recommend a Bill of Rights for consumers of home and community- based long term care services by July 2009. Chair Rex Critchfield called for a motion to undertake this request. Melanie Starns made the motion, Mary Wiley seconded the motion. There was no discussion and everyone was in agreement. This issue will be brought to a future meeting. Many issues were brought up regarding the executive order, such as licensing issues, discharging plan/ basic services, quality of services monitoring, surveys, complaint driven system, incentives for nursing homes with help from the council, toolkits through AZ Links, partners, colleges, libraries, faith based organizations, area agencies and the Ombudsman Program. Mary Wiley, DHS, stated that facility surveys are being redesigned for Internet use and she would bring copies to group for testing in May.
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Interagency Council on Long Term Care ( IACLTC)
Meeting Minutes
February 7, 2007
Page 2
F. Follow- up to January’s Planning Session/ Review and Prioritization of Planned Activities/ Review and Prioritization of Gaps for presentations and discussion at future meetings Chair Rex Critchfield asked everyone to prioritize agency activities for future presentations to and discussions by council. The activities were prioritized as the following:
1.
Dental Coverage
2.
Consumer Direct Care
Dept. of Insurance Information on Liability Insurers
3.
Long- term Care Insurance
Consumer Cooperatives
Falls Prevention Initiative
4. New Ombudsman Training ( DAAS- DES)
DDD senior- focused unit
Spouse as paid caregiver ( AHCCCS)
Aging 2020 Plan
5. Consumer to consumer quality evaluation of services ( DDD)
Better education of physician ( UofA)
Transitional Services – 1time only ( AHCCCS)
Putting information on nursing home and assisted home performance on web ( EO, DHS)
Mature Workforce Initiative ( GACA)
The Gaps were prioritized as following:
1.
Integrate APS with Long- Term Care System, central registry, investigation of facilities and AG central registry to give better information and response.
Older American Act Caregiver language- caregivers of adult children. Coordinating OAA regulations with state appropriation. Still a gap – DD adult children with parents caring for them.
2.
Education of Healthcare Professionals
3.
Nutrition & Hydration of LTC recipients – DHS, CMS, Feeding Assistance Program
4.
Utilizing retired physicians. 3
Interagency Council on Long Term Care ( IACLTC)
Meeting Minutes
February 7, 2007
Page 3
These topics will be slated for future meetings.
G.
Member Announcements
Melanie gave an update on the 7 Senior Action Days, which will consist of a legislative luncheon and a public forum where the State Plan on Aging will be presented.
Chair Rex Critchfield stated the “ draft” Plan on Aging was currently being reviewed by Deputy Director Nelba Chavez and will eventually be posted on the Division of Aging and Adult Services website. The State Plan was very comprehensive.
Chair Rex Critchfield stated the next meeting is scheduled for Wednesday, March 7, 2007. Many stated they would be unable to attend on this date so March 14th was selected for the next meeting. Rex stated everyone would be contacted by e- mail to find out if there would be a quorum for March 14th.
H.
Call for Agenda Items
No additional agenda items were identified.
I.
Call to the Public
Kathleen Pagels stated her thanks to the Governor Napolitano for her leadership and the Executive Order. She further reviewed for the Council the concerns that she and the provider community had with the interpretation of the Executive Order.
J. Adjournment
With no other items, Chair Rex Critchfield adjourned the meeting at 3: 27 p. m. 1
Governor’s Interagency Council on Long- Term Care Council Minutes April 4, 2006
Council Members Present:
Rex Critchfield, Chairperson
Mary Wiley, Vice- Chairperson
Robert Nixon
Jami Snyder
Christina Urias
Alan Schafer
Council Member Absent:
Kathleen Heard
Marian Lupu
Melanie Starns
Uta Brotherton
Senator Carolyn Allen
Representative Bob Stump
Staff Present:
Robin Jordan
Lynn Larson
Pat Talcott
Jutta Ulrich
Guests Present:
Erin Klug
Dick White
Kim Simmons
Call to Order
Call to Order: The meeting was called to order at 1: 08 p. m. by Rex Critchfield, Council Chairperson.
Introductions
Introductions: All individuals who were in attendance introduced themselves.
It was noted a quorum of the council members was present for the meeting.
Minutes Approved
Approval of the February 7, 2007 Meeting Minutes: The members of the Council reviewed and approved the minutes.
The minutes were approved without objection.
AZ Links Project Update
AZ Links Project: Rex Critchfield asked Robin Jordan to present this report. Ms. Jordan reported on the two subcommittees of the Project’s Steering Committee. The Customer Assistance subcommittee is working on the development of a training manual to use for Project partners across the state, which would contain a core set of information on the long term care system. The Uniform Assessment Instrument subcommittee is working on a common assessment form for use by all Project partners.
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Governor’s Interagency Council on Long- Term Care April 4, 2006 meeting minutes
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Governor’s Interagency Council on Long- Term Care
April 4, 2006 meeting minutes
2
Ms. Jordan then spoke about the two regional collaboratives that have begun
meeting. The Mohave County Collaborative is working on a common referral
form, an MOU/ agreement to be signed by all partners, and a client screening
tool. The Maricopa County Collaborative is also working on an
MOU/ agreement for all partners as well as cross- training needs for all
partners.
Project staff are working with DES IT staff to establish a static web page for
the project. The estimated date for the web page to go live is 5/ 1.
Direct Care Workforce Committee Report
Direct Care Workforce Committee: Jami Snyder stated that the Core Curriculum Committee has been meeting. The Committee is considering the
best use of the funding provided through the DES Division of Aging & Adult
Services ( DAAS) to continue to promote the curriculum. One train- the- trainer
course has been conducted. A second session is planned and has approximately
37 individuals signed up to attend. The Region One Area Agency on Aging is
working on the evaluation portion of the project. Jutta Ulrich was introduced
as the new DAAS staff assigned to the Direct Care Workforce issue. Jami also
mentioned that Phoenix College has indicated that they will no longer be able
to provide the coordination of the curriculum for college credits due to
the decrease in the Full Time Student Equivalent funds they receive for each
student. Several members of the Core Curriculum and Expansion
Committee will be meeting with Rio Salado College to coordinate the delivery
of the curriculum for college credits.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: Mary Wiley on behalf of Melanie Starns that meetings have been scheduled for the state agencies referenced in the Executive Order. Activities in progress to meet the Executive Order include: a 2007 Reducing Pressure Ulcers Summit on 5/ 23; a
2007 Reducing Restraints Summit on 6/ 27; the Department of Health Services
( DHS) is revising their web site with nursing home and assisted living facility
information to immediately reflect any change in the home or facility score
based on a visitation or inspection; a Took Kit is being worked on by GACA;
DHS and AHCCCS will be meeting to find a way not to duplicate surveys of
facilities; and the IACLTC will be developing a Patient’s Bill of Rights by
2009.
Dental Coverage – Agency Activity
Dental Coverage: Jami Snyder stated that the Governor’s Council on Developmental Disabilities ( GCDD) had identified dental coverage as a number
one need as part of their planning process for their 5- Year Plan. They had put
together a workgroup on this issue. Alan Schafer reported that this year,
AHCCCS proposed a budget issue that became part of the Governor’s budget
for capped dental coverage for aging, physically disabled and developmentally ___________________________________________
Governor’s Interagency Council on Long- Term Care
April 4, 2006 meeting minutes
3
disabled long- term care eligible individuals, up to $ 1,000 per person. S. B. 1488 limited coverage to the aging and physically disabled long- term care eligible. While optimism is not high on funding for this issue, the 68% match available to AHCCCS for such a program is appealing.
Department of Insurance Information on Liability Insurers – Agency Activity
Director of the Department of Insurance ( DoI), Christina Urias, gave a short presentation. The Nursing Home liability market is experiencing problems nationwide and insurers in Arizona are finding it particular difficult. DoI conducts marketing surveys. They found that of 184 licensed companies responding to their survey, only 3 were writing new business. The average claim against nursing homes has risen from $ 72,000 in 1993 to $ 176,000 in 2004 – a 144% increase in 11 years. Between 1996 and 2000, 15% of all claims exceeded $ 250,000 per claim. Carriers are aware of the severity of these claims, making it difficult to find re- insurers. This forces some nursing homes to turn to the non- admitted market, which is not subject to the same oversight as the admitted insurers. DoI just sent out their 2007 survey and the preliminary returns are indicating a similar situation.
A Report on Arizona Health Insurers was issued in May of 2006. It listed the top 25 insurers doing business in Arizona. It further disclosed that about 50% of the time, insurers will overturn their original decision on payment of claims if it is appealed.
Christina mentioned a New York Times article that was a scathing review of Long Term Care Insurance. One of its main criticisms was that, since it was a new type policy, many insurers originally set their premiums too low and policyholders are now experiencing 35% and 25% yearly increases. She reminded the Council that DoI can approve or disapprove rates on individual Long Term Care policies. However, only 15 complaints had been received by DoI in 2005 and 8 complaints in 2006 about Long Term Care policies.
Member Announcements
Jami Snyder – Announced that she was leaving the GCDD as their Executive Director and was taking a position with DHS.
Alan Schafer – AHCCCS’ contract to develop a consumer directed care model was moving forward and was basically on schedule, as was another initiative to pay spouses as caregivers up to 40 hours per week, another initiative moving into place is to provide funding for transition services to move from a nursing home back into the person’s home, and they have received a half- million dollar grant to assist persons with a disability obtain employment to move off Medicaid.
Call for Agenda Items
Rex suggested that for the next meeting, the Council receive presentations on the Falls Prevention Initiative ( an Agency Activity) and on DD Adult Children with Parents Caring for Them ( a Gap).
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Governor’s Interagency Council on Long- Term Care
April 4, 2006 meeting minutes
4
The next meeting will be July 11 – not July 4th, the traditional meeting date because it is the first Wednesday in July. Notification will be sent to members to determine availability.
Call to the Public
Dick White – The National Life Span Respite Care bill has made it to the negotiation stage at the federal level. S. B. 1317, the state level counterpart, is doing well and has passed out of the Appropriations Committee by a unanimous vote. Dick also mentioned that there are ongoing discussions with DES to integrate or coordinate a statewide Caregivers Coalition with a statewide Respite Care Coalition.
Kim Simmons – Asked Director Urias’ whether the liability insurers for DDD group homes were the same insurers for nursing home. Director Urias responded in the affirmative.
Adjournment
The Chairperson adjourned the meeting at 3: 02 p. m.
___________________________________________
Interagency Council on Long- Term Care
July 11, 2007 meeting minutes
1
Interagency Council on Long- Term Care Council Minutes July 11, 2007
Council Members Present:
Rex Critchfield, Chairperson Mary Wiley, Vice- Chairperson Uta Brotherton
Alan Schafer
Erin Klug Robert Nixon
Cynthia Gafford
Council Member Absent:
Kathleen Heard
Melanie Starns
Senator Carolyn Allen Representative Bob Stump
Staff Present:
Lynn Larson Pat Talcott
Jutta Ulrich
Greta Mang
Guests Present:
Kim Simmons
Kathleen Pagels Genny Rose Karen Barno
Call to Order
Call to Order: The meeting was called to order at 1: 10 p. m. by Rex Critchfield, Council Chairperson.
Introductions
Introductions: All individuals who were in attendance introduced themselves.
It was noted a quorum of the council members was present for the meeting.
Minutes Approved
Approval of the April 4, 2007 Meeting Minutes: The members of the Council reviewed and approved the minutes. The minutes were approved without objection.
AZ Links Project Update
AZ Links Project: See attached report.
Direct Care Workforce Committee Report
Direct Care Workforce Committee: Jutta Ulrich reported on the progress of the project and the recommendations from the Core Curriculum and Expansion Committee’s strategic planning meeting, which included a direct care workforce training, parameters of the training program including tiers of certification, explore delivery methods, curriculum pilot in a rural area, ___________________________________________
Interagency Council on Long- Term Care
July 11, 2007 meeting minutes
2
continued training activities and evaluation in Maricopa and Pima counties, and subcommittees to implement the recommendations. The committee also advised the IACLTC that a public policy plan is needed to address the larger issues surrounding the direct care workforce in Arizona. Jutta advised that the project’s planned activities for FY2008 include expansion of the curriculum into Pinal- Gila region, continued training and evaluation in Maricopa and Pima counties, and the development of a ‘ hybrid” web- based course.
The Council asked the committee to come back to the next Council meeting with an agreed upon name for the committee, a membership list, and a work plan.
Alan Schafer agreed to become the new committee chair.
Uta Brotherton recommended that the committee check out collaboration possibilities with the Department of Commerce’s Apprenticeship Program.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: No report on this activity.
Ombudsman Training
Ombudsman Training: Bob Nixon advised there would be new Ombudsman training through out the state to all volunteers which would lead to certification and everyone would be provided with an updated manual. Also at their request, this training would included the Native Americans tribes.
State Plan on Aging
State Plan on Aging. Lynn Larson provided a handout on the State Plan Goals and Objectives and reported the State Plan on Aging was approved by the Governor’s Advisory Council on Aging. The next steps would be approval by DES management and the Governor.
Member Announcements
Member Announcements. Rex announced that the Legislature had appropriated $ 500,000 in state funds to the DES Division of Aging and Adult Services for the development of a statewide respite coalition and for the provision of respite care services.
Erin Klug advised the long- term care insurance brochure provided to the Council a few meetings back by the Department of Insurance is now on their website and to contact her if there was any questions or concerns regarding long term care insurance.
Alan Schafer reported on the state appropriation to AHCCCS of $ 1,000 per person for non- emergency Adult Dental Care, which does not include dentures. Alan stated a policy is being drafted to be provided to AHCCCS management ___________________________________________
Interagency Council on Long- Term Care
July 11, 2007 meeting minutes
3
regarding payment to caregiver spouses who provide healthcare 7 days a week. Also in the works is a Community Reintegration Program to assist someone moving from a nursing home back into their own home, which would provide $ 2,000 per member within a 5 year period for utility deposits and basic furnishings.
Alan stated that AHCCCS will launch a Consumer Directed Care program targeted to start October 1, 2007. This program will allow the consumer to delegate service tasks. Implementation issues are still being worked through, such as fiscal agent unemployment insurance.
AHCCCS has received a $ 500,000 Medicaid grant in collaboration with Medicaid Freedom to initiate an Arizona Health and Disability Partnership program to assist members who are working or wanting to go back to work. It is designed to better link the independent living systems with the employment network. Derek Johnson is Project Manager of the 3- year grant.
Call for Agenda Items
Agenda Items. Rex advised at the next IACLTC meeting on September 5, 2007 the Council will receive a draft of the Annual Report so it could be approved at the October 3, 2007 meeting instead of waiting until the November 7, 2007 meeting for approval.
Call to the Public
No comments.
Adjournment
The Chairperson adjourned the meeting at 3: 00 p. m.
AZ Links Update JULY 1, 2007
Regional Collaboratives
Cross Training Materials have been developed by the CAC Committee.
􀂃
Finalization of those materials will be determined at the July 18th Meeting.
􀂃
A contractor will compile all materials into an instructional manual and desk reference.
Cross Training –
􀂃
Mohave Regional Network have developed training outlines and set three training days – 2 in September and one in October. Staff participating in the cross trainings have also been identified.
􀂃
Maricopa Regional Network has determined their regional training format and will
determine dates for those cross trainings at their July meeting. They expect to
hold the trainings in October/ November timeframe.
Website Development –
􀂃
AZ Links website is expected to go live the last week in July. It is being developed by the PIO office. It will be located on the DAAS website and will also have a separate URL: www. azlinks. gov.
􀂃
This site will have links to various websites arranged by topic. However it will not be interactive. Topics include: Aging and Other Resources; Caregiver Resources; Employment; Financial Help; Fitness, Health & Nutrition; Fraud, Scams & Legal Matters; Housing Options; Independent Living Supports; Insurance, Medicare & Other Benefits; Long Term Care Choices; Personal Safety; Socialization/ Recreation; Transportation; Tribal Resources; Volunteering.
􀂃
Website Continuing Development – Interactivity will be built as this website is developed to include the Screening Tool and a Common Intake.
Background: Following the formal agreement between AHCCCS and DAAS, AHCCCS has appointed Linda Schwank to work with us to develop the website connection with AHCCCS.
􀂃
Linda Schwank is currently developing a work plan to develop the functionality of the website and proposes to launch a Pilot with functionality.
Focus groups are being assembled to give feedback on both the Screening Tool and the Website once the website is launched.
􀂃
The Governor’s Council on Developmental Disabilities has identified persons with developmental disabilities, persons with physical disabilities in both Pilot regions.
􀂃
The Area Agency on Aging in Region One and Region 4 are providing participants representing the aging community.
Screening Tool – is currently being tested for validity in Mohave and Maricopa Counties.
􀂃
It has been installed on the WACOG AAA Region 4 website ( English and Spanish translations). 􀂃
Installation of the Screening Tool on the AAA, Region One website is expected any day.
Background: The Screening Tool is designed to be a self- help tool. Following data entry, it is sent to an Information Specialist who then calls the person and assists in locating the services they are requesting, or referring to the most appropriate agency.
Common Intake Matrix – A Common Intake is being developed by the Uniform Assessment Instrument committee. Kris Bursac has incorporated committee recommendations, and will present a Final Draft at the UAI Meeting on July 18th . If approved, it will be forwarded for Steering Committee approval on August 1.
Triggers – Identifying the elements that determine where the consumer should be directed.
􀂃
Expected Completion: August, 2007.
Background: The UAI committee members have submitted the triggers and are now creating a decision tree to determine which of their respective agencies are the most appropriate to handle the specific individual’s needs. This will guide IT development, to provide the information on agencies that will most likely provide the services needed.
Inventory of Services – The Customer Assistance Committee has agreed on a list of 40 service categories and 143 services available from the partner agencies, state and federal programs. This inventory will help I & R staff in directing consumers to the correct agency. The value of this Inventory:
1)
Helps staff from other agencies know what each agency provides;
2)
Provides easy location of services based on a category of services;
3)
Illustrates if there are gaps in services;
4)
Using AIRS taxonomy as well as other agreed upon service categories, facilitates search capabilities when a database is developed on the website.
Inventory of Sites – A complete list of locations ( 365) throughout the state has been compiled. Agencies include DES, AHCCCS, DDD, AAA offices. Other service locations include Benefits Check Up, AZ Secure, and SHIP sites.
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Interagency Council on Long- Term Care
September 5, 2007 meeting minutes
1
Interagency Council on Long- Term Care
Council Minutes
September 5, 2007
Council Members Present: Rex Critchfield, Chairperson
Mary Wiley, Vice- Chairperson
Alan Schafer
Erin Klug
Greta Mang
Melanie Starns
Franc Kahn
Council Member Absent: Jan Lesher/ Uta Brotherton
Senator Carolyn Allen
Representative Bob Stump
Staff Present: Lynn Larson
Pat Talcott
Robin Jordan
Allie Masters
Guests Present: Kim Simmons
John Linda
Fran Atkinson
Jana Bertucci
Andy Weiler
Call to Order Call to Order: The meeting was called to order at 1: 33 p. m. by Rex Critchfield, Council Chairperson.
Introductions Introductions: All individuals who were in attendance introduced themselves. It was noted a quorum of the council members was present for the meeting.
Minutes Approved Approval of the July 11, 2007 Meeting Minutes: The members of the Council reviewed the minutes and Melanie Starns asked for removal of “ Governor’s” before Interagency Council on Long Term Care title. Alan Schafer moved to approve the minutes. Greta Mang seconded the motion and the minutes were approved without objection.
Update on Council Membership
Update on Council Membership: Rex Critchfield, Council Chairperson, stated that Senator Meg Cahill would be the new representative for the Senate. Area Agency on Aging urban and rural representatives have been accepted and the Council is awaiting their signed Oaths of Office. Greta Mang, new supervisor over the Ombudsman Program, replaces Bob Nixon the Council. The Council roster will be updated to reflect the changes. ___________________________________________
Interagency Council on Long- Term Care
September 5, 2007 meeting minutes
2
AZ Links Project Update
AZ Links Project: Allie Masters reported the launching of the website, through DES and stated the site provides a plethora of levels of information for aging, developmental disabled, and disabled. She stated the website is a work in progress and welcomes suggestions. A project manager from AHCCCS has been assigned to help develop the AZ Links web application. Regional networks have been established in Mohave and Maricopa counties, bringing together Area Agencies on Aging, the Division of Developmental Disabilities, AHCCCS, and the independent living agency. Staff cross trainings will occur from September through December. Chairperson Critchfield stated there had been coordination with the Governor’s Council on DD to have focus groups evaluate the maneuverability, accessibility, assessments, and improvements to the AZ Links website.
Direct Care Workforce Committee Update
Direct Care Workforce Committee: Alan Schafer stated they have been meeting through the first part of the year establishing 3 sub committees on curriculum, training, implementation, and marketing aspects. Chairperson Critchfield clarified that the Governor’s Advisory Council on Aging ( GACA) is forming a caregiver coalition group focused on the unpaid caregiver. Lynn Larson further clarified that the DAAS is developing a Lifespan Respite Care Program, through a $ 500,000 state appropriation, which will assist individuals who do not qualify for current respite programs. Criteria are in development for those who will be serviced.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: Melanie Starns reported that half of the objectives of a work plan to accomplish the Executive Order have been accomplished. Accomplishments have included a Conference on the Use of Restraints by ADHS ( 250 attendance) and ADHS has on- line survey results for nursing homes and childcare which are more user friendly. A press release about a Tool Kit for use in facilities was issued last week and is a good resource for the ombudsmen. Next year’s work will include a Consumer Bill of Rights for Home Based Care.
Falls Prevention Initiative
Falls Prevention Initiative: Andrew Weiler stated that he is chairing a subcommittee of the GACA which is developing a track on Falls Prevention for the Governor’s Conference on Aging for May 2008 in Tucson. Mr Weiler stated that he was also working to develop a survey tool to detect the likelihood of a person falling. Chairperson Critchfield suggested that APS workers would benefit from having such a survey to administer to their clients. Free standing tools are available now. Co- chair Mary Wiley stated cards on the signs of abuse are currently being given to paramedics.
Draft Annual Report
Draft Annual Report. Chair Critchfield stated that the Council’s Annual Report is due to the Governor and the Legislature on the 15th of November. This year’s draft Report includes a section on results of the Council’s strategic ___________________________________________
Interagency Council on Long- Term Care
September 5, 2007 meeting minutes
3
planning session in January, reports on the three committees, and uses the seven public meetings that DAAS used around the state to collect input on their State Plan on Aging. Comments on the draft Annual Report are needed within 2 weeks. Changes will be incorporated and sent back out to the Council in a week. Next meeting will be on Wednesday, October 17, 2007 @ 2: 30 p. m.
Member Announcements
Alan Schafer announced that dental services with a one time authorization for $ 1,000 through the ALTCS Program would now be available from October 1, 2007 through September 30, 2008. Also starting October 1st is a payment for up to 40 hours of in- home service in a 7 day period for caregiver spouses. Community Integration payments will be available for settling into one’s own home/ apt., to include furniture, utility deposits, etc. The $ 2,000 allowance is available every 5 years. The Self Directed Care project is delayed until April 2008.
Greta Mang reported that on October 18, 2007, an Ombudsman Quarterly Meeting will be held and include APS and the AG’s office. The meeting will have a legal theme. Greta, as the new Ombudsmen Program supervisor, will be making statewide visits, is in the process of planning a two day annual meeting, is working on the Nursing Home Resident Rights Brochure, and will be re- designing and updating current booklets and posters. Greta advised that October 7- 14 is Residents Rights Week.
Melanie Starns announced that the Governor will officially open the new Governor’s Office on Aging at 11: 00 a. m. on September 7, 2007. There will be an Open House and everyone is invited to attend.
Call for Agenda Items
None
Call to the Public
John Linda stated that although his office has moved, their e- mail and phone number have not changed.
Adjournment
The Chairperson adjourned the meeting at 2: 57 p. m.
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Interagency Council on Long- Term Care
October 17, 2007 meeting minutes
1
Interagency Council on Long- Term Care
Council Minutes
October 17 2007
Council Members Present: Rex Critchfield, Chairperson
Mary Lynn Kasunic
Lisa Wynn for Mary Wiley, Vice- Chairperson
Mary Butterfield for Erin Klug
Greta Mang
Melanie Starns
Franc Kahn
Council Member Absent: Mary Wiley, Vice- Chairperson
Alan Schafer
Jan Lesher/ Uta Brotherton
Senator Carolyn Allen
Representative Bob Stump
Senator Meg Burton Cahill
Representative Barbara McGuire
Jill Harrison
Staff Present: Jutta Ulrich
Pat Talcott
Allie Masters
Guests Present: Kim Simmons
Kathleen Pagels
Annette S. Quinata
Heidi Otis
Jana Bertucci
Judy Clinco
Call to Order Call to Order: The meeting was called to order at 2: 31 p. m. by Rex Critchfield, Council Chairperson.
Introductions Introductions: All individuals who were in attendance introduced themselves. Rex Critchfield, Council Chairperson, welcomed Mary Lynn Kasunic as a new member of the council and presented her with a certificate and oath of office.
Minutes Approved Approval of the September 5 , 2007 Meeting Minutes: The members of the Council reviewed the minutes and Melanie Starns asked for the following revisions: page 2 under Direct Care Workforce Committee, second line should be meeting not meetings and under Falls Prevention Initiative, first line should read as follows, Andrew Weiler stated that he is chairing a subcommittee of the GACA which is developing…. etc. Chairman Critchfield asked for approval as ___________________________________________
Interagency Council on Long- Term Care
October 17, 2007 meeting minutes
2
amended. Melanie Starns motioned for approval, Greta Mang seconded the motion and the minutes were approved as amended.
Update on Council Membership
Update on Council Membership: Rex Critchfield, Council Chairperson, stated the council roster was updated to reflect the changes in the council and available to everyone at this meeting..
AZ Links Project Update
AZ Links Project: Allie Masters reported eventually AZ Links will have its own database and server but for now the website is static. Through a “ real time” presentation Allie demonstrated the different methods of accessing information on the site and provided information by Google Analytics about how many hits the website has received, the amount of time each page is viewed and which pages were viewed the most from August 1, through October 15, 2007. Allie stated the Contact Us feature was being utilized and suggestions were made for an “ Exit Survey” button.
Direct Care Workforce Committee Update
Direct Care Workforce Committee: Jutta Ulrich provided the information for Alan Schafer, who was unable to attend the council meeting. Jutta reported a Programs Contractor meeting was held and 3 subcommittees are working on their plans and will report to the full committee in the spring. The three sub- committees are the Standards and Certification, Teaching and Delivery Methods and Public Education and Marketing.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: Melanie Starns stated there was nothing new to report.
Draft Annual Report
Annual Report. Chair Critchfield asked for a motion for the approval of the Annual IACLTC report which is due to the Governor and Legislature by November 15th. Mary Lynn Kasunic asked for revisions on page 3, Section IV. Meeting Dates, removal of November 6, 2007 and addition of today’s meeting date of October 17, 2007, and under Gap Areas, removal of apostrophe to Older Americans Act. Melanie Starns asked for a revision on page 9, third paragraph, first line, the removal of “ about” at the end of the line. Mary Lynn Kasunic made the motion to approve the report, Franc Kahn seconded the motion and the report was approved as amended.
Arizona Direct Care Worker Association
AZ Direct Care Worker Association: Judy Clinco, of the AZ Direct Care Worker Association through a PowerPoint Presentation and hand- out, shared the goals of the newly created organization based in Tucson, Arizona. It is a not for profit 501 ( C)( 3) and is a membership and advocacy organization that hopes to provide Public Education and Awareness, positive changes in the Public Perception of the Direct Care Worker and Membership Services for the Direct Care Workers. ___________________________________________
Interagency Council on Long- Term Care
October 17, 2007 meeting minutes
3
Member Announcements
Member Announcements: Greta Mang announced the resignation of Bob Nixon, Ombudsman for DAAS on October 5, 2007 and stated a new ombudsman would be hired. Greta stated the quarterly gathering of Ombudsman and Volunteers, APS, and the Attorney General’s Office would be taking place tomorrow in Casa Grande. There would also be a quarterly meeting regarding health care coming up. Greta also informed everyone she had redesigned the Arizona Long Term Care Ombudsman brochure and passed around a limited copy for everyone to view. The brochures will be available in English and Spanish and are not yet in full production and only a few were printed for tomorrow’s gathering.
Call for Agenda Items
No agenda items were presented. Rex Critchfield announced the next IACLTC meeting would be on Wednesday, February 6, 2007 from 1: 30 to 3: 30 p. m.
Call to the Public
Kim Simmons stated DDD is in their 3rd year of Direct Support Recognition and asked agencies be contacted for any nominations. Kim stated Friday, November 9th is Direct Support Professional Day.
Adjournment
The Chairperson adjourned the meeting at 4: 10 p. m.

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Full Text

ARIZONA
INTERAGENCY COUNCIL ON
LONG- TERM CARE
2007 ANNUAL REPORT
Prepared by:
Interagency Council on Long- Term Care
November 15, 2007
Equal Opportunity Employer/ Program
This document is available in alternative formats by contacting
The DES ADA Coordinator at 602.542.6572 Interagency Council on Long- Term Care
2007 Annual Report
I. Background
In 2001, the Legislature passed Senate Bill 1196 and created the Interagency Council on Long- Term Care ( Interagency Council). Pursuant to A. R. S. § 41- 4102, the purpose of the Interagency Council is " to help the state achieve a coordinated long- term care services delivery system." Additionally, the Interagency Council is required to " define this state's long- term care obligations by coordinating applicable state and federal mandates that relate to long- term care services." This report is prepared pursuant to A. R. S. § 41- 4102( C).
II.
Council Operating Guidance
Council Vision Statement
The Long- Term Care System in Arizona will be a family- friendly continuum of services that is person- centered involving seamless partnerships of the medical, social, physical, and mental health communities.
Council Mission Statement
Improve the quality of life for Arizona residents through a coordinated long- term care delivery system.
Council Purpose
The purpose of the Interagency Council is to help the state achieve a coordinated long- term care services delivery system. Additionally, the Interagency Council is required to define this state’s long- term care services including quality of care issues, access to services, and coordination/ integration of those services.
III.
Membership
Arizona Revised Statute § 41- 4101( A) mandates the Interagency Council's representation be the directors or the designees of the following departments:
• Department of Health Services ( DHS)
• Department of Economic Security ( DES)
• Arizona Health Care Cost Containment System ( AHCCCS)
• Department of Commerce ( DOC)
• Department of Insurance ( DOI)
The following individual representation was made as appointments:
• Executive Director of the Governor's Advisory Council on Aging
• Executive Director of the Governor's Council on Developmental Disabilities
• State Long- Term Care Ombudsman
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In addition, the following additional representation was made as three year appointments:
• One representative from an Agency on Aging in an urban area
• One representative from an Agency on Aging in a rural area
• Two members of the House of Representatives ( nonvoting)
• Two members of the Senate ( nonvoting)
Appointments to the Interagency Council are for three- year terms. A roster of the current appointments is attached as Appendix A.
IV.
Meeting Dates
The Interagency Council on Long- Term Care ( Council) is required to meet four times a year according to statute. The Council met on the following dates:
January 3, 2007 – Strategic Planning meeting
February 7, 2007
April 4, 2007
July 11, 2007
September 5, 2007
October 6, 2007
The Council’s January meeting was a strategic planning meeting devoted to identifying Gap Areas within the long- term care system and Agency Activities for the Council. It was the Council’s intent to entertain presentations on Gap Areas and Agency Activities at each of its 2007 meetings. Gap Areas were defined as areas where more work needed to be done and the Council’s membership could consider additional strategies to address the needs. Agency Activities were defined as new programs or initiatives that Council members were unaware of and could benefit from learning more about. The attached meeting minutes ( Appendix B) describe presentations made to the Council.
Gap Areas
􀂃
How to better give people information about the long- term care system and its options
􀂃
How to better integrate Adult Protective Services into the long- term care system
􀂃
Education of healthcare professionals
􀂃
Nutrition and hydration of long- term care recipients
􀂃
Impact of “ Choices” on home and community based services
􀂃
Lifespan respite care federal legislation, and the need for a statewide coalition for information and coordination
􀂃
Utilizing retired physicians and other healthcare workers, i. e., dentists
􀂃
Older Americans Act caregiver language – caregivers of adult children
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Agency Activities
􀂃
Long- Term Care Insurance
􀂃
New Ombudsman training
􀂃
Dental coverage
􀂃
Falls prevention initiative
􀂃
Department of Insurance information on liability insurers
􀂃
Department of Economic Security Division of Developmental Disabilities senior- focused unit
􀂃
Consumer to consumer quality evaluation of services
􀂃
Better education of physicians
􀂃
Education practioners and workers with disabilities
􀂃
Consumer directed care
􀂃
Transitional services – 1 time only
􀂃
Putting information on nursing home and assisted home performance on web
􀂃
Spouses as paid caregivers
􀂃
Consumer cooperatives
􀂃
Mature Workforce Imitative
􀂃
Aging 2020 Plan
V.
Council Projects
The Council assumed responsibility for oversight of two major cross- agency, long- tem care system coordination projects a year ago. The Council has established working committees to manage both these projects.
AZ Links: the Aging and Disability Resource Center project.
In September of 2005, the DES Division of Aging & Adult Services ( DAAS) was notified by the federal Administration on Aging that it had been awarded an Aging and Disability Resource Center ( ADRC) grant for $ 750,000 over three years. DES/ DAAS is partnering with AHCCCS, the Governor’s Council on Aging, the Governor’s Council on Developmental Disabilities, DES/ Division of Developmental Disabilities, Area Agencies on Aging, the Arizona Bridge to Independent Living, community aging and disability groups, and the University of Arizona in working toward creating a single, coordinated system of information, assistance, and access for all persons seeking long- term care ( LTC) services. In Arizona, this effort is known as the AZ Links Project.
Information about and access to LTC services must be available to all of Arizona’s citizens to plan for and make informed decisions about their future needs in the most cost effective manner while choosing from a panoply of options that promote choice, independence and dignity. Persons seeking services from the state and its contractors need to have a system that allows them to proceed from information and referral to eligibility application and determination to service acquisition, and finally, to service coordination. To accomplish these goals, the state is working toward developing a comprehensive, seamless information, referral, and eligibility system along with the necessary data
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management infrastructure. A committee of the Interagency Council on Long- Term Care will serve as the advisory committee to this grant project.
AZ Links is being rolled out using two strategies:
Regional Collaboratives
Collaboratives consisting of staff from area agencies on aging, DES Division of Developmental Disabilities, independent living centers, and Arizona Health Care Cost Containment System ( AHCCCS) have been formed in Mohave and Maricopa counties. Members are focusing on cross- training within the system and common assessment and referral protocols to provide a “ no wrong door” for clients.
AZ Links Website
A beginning static website with pages of information and useful links went live on August 1, 2007 with the URL of www. azlinks. gov. Future plans for the site include the opportunity for consumers to establish their own accounts and for the site to have a common assessment, intake, and referral capability.
The Direct Care Workforce Training effort.
In April 2005, the Citizens Workgroup on the Long- Term Care Workforce issued their recommendations to Governor Napolitano in a report titled, “ Will Anyone Care? Leading the Paradigm Shift in Developing Arizona’s Direct Care Workforce.” The report offered 10 recommendations to improve the direct care workforce capacity and supply:
1.
State agencies must establish and implement policies to support informal/ family caregivers to ensure that the demand for professional caregivers does not outweigh supply and thus exacerbate the financial challenge already facing an overburdened system.
2.
State agencies responsible for regulating oversight of direct care workers must develop a standardized, uniform, and universal training curriculum.
3.
Plans developed by state agencies that serve elders and people with disabilities should be modeled on the concept of person- centered care.
4.
One state agency should be identified as the focal point for resource development for health care workforce initiatives, and designated to play a proactive role in seeking state, federal, and private grants to further develop Arizona’s direct care workforce.
5.
State policy must require and fund health insurance and benefits for direct care workers in long term care settings.
6.
Public and private sector employers must fundamentally re- evaluate the wages paid to the direct care workforce and balance this with the value of the services they provide.
7.
Funding for pilot projects to enhance direct care workforce recruitment and retention in long term care should be identified.
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8.
The state should mount a public awareness campaign to promote the image and profile of the direct care workforce.
9.
The state should continue to support and develop preventative health care programs.
10.
Support the incorporation of long- term care workers into existing professional associations, or the creation of an association dedicated to the direct care worker in the long- term care setting.
The Citizens Workgroup on the Long- Term Care Workforce, Education and Training subcommittee developed a training curriculum to provide the basis for a standardized, universal, and uniform training. The core curriculum is 30 hours and includes the following competencies: client’s rights/ dignity, basics of documentation, HIPPA/ confidentiality, stress and time management, basic principles of personal care, lifting, assistive devices, nutrition, and health and safety. The core curriculum was piloted in June 2005 at Phoenix College. An aging and physical disabilities module and developmental disabilities module were reviewed by the curriculum development committee at Phoenix College, and course competencies were established for the Maricopa County Community College System. There are plans to pilot the core and two modules at Phoenix College in the fall of 2007. Pima Community College offered two courses in the summer of 2007 and is planning two additional courses in the fall of 2007.
Building on the activities of the Citizens Workgroup on the LTC Workforce, the Council has established a committee to direct the long- term care workforce effort. As a result of Council discussion, DES, AHCCCS, and ADHS have come together to jointly fund a Direct Care Workforce Specialist position within the DES/ DAAS to assist the subcommittee in the project’s management, to serve as a resource for direct care workforce initiatives, and to further develop Arizona’s direct care workforce.
DES/ DAAS has directed $ 100,000 to train direct support professionals in Maricopa, Pinal, and Pima counties using the standardized training curriculum through the Maricopa and Pima Community College systems. As a result of a Committee strategic planning meeting held on May 24th, other project directions for the current year include: ( 1) The direct care worker training process should initially focus on employees of state- funded agencies providing in- home services. This should include both new and existing employees. ( 2) A subcommittee should prepare a recommendation for the parameters of the training program, including tiers of certification and a timeframe. ( 3) A subcommittee should pursue the discussion of delivery methods and instruments for the assessment of theoretical and practical knowledge.
Completed Project Activities
1.
The Maricopa County Area Agency on Aging sent an invitation for participation on January 22, 2007, to providers. It briefly described the project and announced the training sessions for trainers.
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2.
The training manuals for the Core, the Aging & Physical Disabilities, and the Developmental Disabilities module were completed and printed by DES. Toolkits with teaching materials and DVDs were assembled for all three classes. Master trainers are:
Core: Susan Kilby ( FSL) and Diane Patton ( ABIL)
E/ PD: Susan Kilby ( FSL) and Diane Patton ( ABIL)
DD: Wendy Ketterer ( AIRES)
3.
The two trainings were conducted as planned in February and April. Forty- one individuals attended the Core and one ( or both) of the two modules.
􀂃
Trained instructors/ representatives of agencies: Core 41
􀂃
Trained instructors/ representatives of agencies: Aging/ PD 26
􀂃
Trained instructors/ representatives of agencies: DD 27
􀂃
Agencies represented: 27
􀂃
Agencies agreeing to test the curriculum ( or selections): 20
􀂃
Agencies that signed an agreement to train 10 direct care and support professionals, ideally by June 30, 2007, received a toolkit.
4.
Two instructors from Pima Health System attended the training in Phoenix and will work with Pima Community College in Tucson to offer classes for direct care and support professionals. The first class started May 12, 2007. Over 30 individuals had signed up and 13 completed the course. Twenty- two students completed the second class in July 2007. The college offers a certificate and college credits to participants; tuition is paid from the funds made available by DES to the Pima Council on Aging.
5.
CJ O’Connor of the Maricopa County Area Agency on Aging has developed a plan for the evaluation of the project. She conducted telephone interviews with participants of the February session, and she has developed questionnaires for trainers and the direct care and support professionals receiving the training.
Plans for the Future
1. Pima Community College is planning to offer two additional courses in the fall of 2007. The college is also planning the development of a hybrid course. The training project is expanding to Pinal/ Gila region, with Pinal/ Gila Council for Seniors exploring implementation in rural areas. In Maricopa, three provider agencies will offer training through Phoenix College.
2. Project leaders and DES staff will follow up with the agencies that attended the trainings to promote the use of the curriculum in their training.
3. Through follow- up activities and formal evaluations, the acceptance of the curriculum and details regarding implementation will be assessed.
4. Project leaders and DES staff will work with the Core Curriculum and Expansion Committee to develop suggestions for further implementation and revisions.
5. Work continues on the Alzheimer’s Disease and Dementia module, and there are plans for a module on behavioral health.
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Executive Order 2007- 01 on Ensuring Quality in Long Term Care
The Governor established an Executive Order to address quality in long term care. The Departments of Health Service, Economic Security, and AHCCCS and the Governor’s Interagency Council on Long- Term Care were specified to play key roles in implementing the Order. The Executive Order specified a set of eleven Objectives for the next three years:
Objective 1: DHS, DES, and AHCCCS shall develop a comprehensive three- year strategy to improve quality in long term care, including focusing on nursing homes in the first year, assisted living in the second year, and community care in the third year.
Objective 2: DHS, AHCCCS, and DES, in collaboration with program contractors and the long term care industry, shall set goals and take measures to reduce Arizona's rates of pressure ulcers and restraint use in nursing homes, with a minimum goal of achieving and/ or sustaining rates well below the national average.
Objective 3: AHCCCS, DHS, and DES shall work together with the Arizona Long Term Care System program contractors to address and correct quality of care deficiencies in long term care facilities.
Objective 4: Beginning in FY08, and as permitted by law, DHS shall develop incentives for nursing homes that have achieved top quality care, based on criteria
set by the department and as measured and verified through the annual survey and quality rating processes.
Objective 5: DHS, AHCCCS, and DES shall enter into intergovernmental service agreements, using existing resources, to jointly staff a full- time position within the DES Division of Aging and Adult Services to work with community advocates, long term care providers, community colleges and other entities as deemed necessary to address the shortage of long term care direct care support professionals in Arizona.
Objective 6: DHS shall continue to take the lead in holding conferences to educate direct care staff about how to prevent pressure ulcers and properly use restraints, with the next such conference to occur before the end of 2007.
Objective 7: DHS shall post Quality Ratings of individual nursing homes on the department's website by no later than July 2007.
Objective 8: DHS shall post regulatory surveys for nursing homes and assisted living facilities on its website to provide consumers with quality information about assisted living facilities beginning no later than January 2008.
Objective 9: DHS, AHCCCS, and DES shall collaborate to develop a Consumer's Long Term Care Toolkit to provide Arizona families with the information, resources and guidance needed to make informed decisions about long term care.
Objective 10: DHS, during its survey process of nursing homes and assisted living facilities, shall foster better understanding and compliance with federal law regarding the provision and appropriate explanation of the Residents' Bill of Rights to all residents.
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Objective 11: By July 2009, the Interagency Council on Long Term Care is requested to recommend a Bill of Rights for consumers of home and community- based long term care services.
VI.
Listening Session
Pursuant to § A. R. S. 41- 3901( D), the Interagency Council must hold a public meeting to solicit comments on ways to improve Arizona’s Long- Term Care delivery system from the community so that it:
•
Ensures the dignity of consumers;
•
Meets the individual needs of consumers;
•
Provides high quality programs and services;
•
Provides an opportunity for consumers to choose and have input in their services;
•
Enhances home and community- based care;
•
Integrates funding sources to provide affordable services; and
•
Coordinates state and federal mandates.
Every two years, the Governor’s Advisory Council on Aging sponsors Senior Action Day at the Legislature. Traditionally this was an event on the Capitol lawns where seniors gathered for an opportunity to meet with their legislators and have some fun. Unfortunately, that also meant that a lot of people didn’t participate, because they could not or would not drive to Phoenix. So this past year the Council decided to try something different --- LOCAL Senior Action Days!
This past spring, the Council held a local Senior Action Day event in seven communities across Arizona. The first event of the day was a luncheon for legislators and concerned seniors from their respective legislative districts. The luncheons were designed to allow legislators to participate and learn more about the issues that affect older Arizonans and the role they can play in helping us all remain in our own homes and communities throughout our lives.
Following the luncheons, public hearings were convened on- site to review the State Plan on Aging. The hearings were 1 ½ hours long. The public hearings were facilitated and generally were introduced by the host city Mayor and the legislators who stayed over from the luncheon. Five of the Plan’s eight Goals were covered and the main initiatives planned for each Goal. Written and verbal input was then solicited for each Goal.
The Chair of the Interagency on Long- Term Care participated in each of the public hearings. The broad scope of the State Plan on Aging allowed for consumer input across the breath of the long term care continuum. Given the extensive input received from these seven hearings across the state, they served as the Council’s listening session for 2007.
Below is a listing of dates and locations of the Senior Action Days.
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SENIOR ACTION DAYS - 2007
Date: Area & Districts/ Event Location
February 23rd Includes East Valley ( Maricopa) and Pinal districts of 8, 17, 18, 19, 20, 21, 22, & 23. Event held in Mesa at East Valley Senior Services Center.
March 16th Includes Mohave, La Paz, Yuma counties, districts 3 & 24. Event held in Parker at the Parker Senior Center.
March 23rd Includes North Phoenix, Paradise Valley, Scottsdale, Cave Creek/ Carefree districts of 6, 7, 8, 10, & 11. Event in Paradise Valley Senior Center.
March 30th Includes Central Phoenix, West Valley & Pinal districts of 9, 12, 13, 14, 15, 16, & 23. Event held in Avondale.
April 13th Includes upper northwest valley, Yavapai, & Coconino County districts of 1, 2, & 4. Event held at the Prescott Community Center.
April 20th Eastern & NE Arizona ( Coconino, Apache, Gila, Graham, Navajo counties), including districts 2 & 5. Event held in Globe, at the Globe City Hall.
April 27th Tucson and Southern AZ, ( Pima, Cochise, Santa Cruz, Greenlee counties) including districts 25, 26, 27, 28, 29, 30. Event held in Tucson at a senior center.
VII.
Next Steps
The Council will devote one of its first meetings in 2008 to a planning session to determine priority projects, in addition to the AZ Links Project and Direct Care Worker Training, with which the Council wants to become more involved. The Council will also continue to remain involved in the critical projects mentioned above to further the coordination, collaboration and improvement of Arizona’s Long Term Care System.
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APPENDIX A
INTERAGENCY COUNCIL ON LONG- TERM CARE MEMBER ROSTER
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2008 Interagency Council on Long- Term Care Roster Ms. Tracy Wareing, Director Ms. Jan Lesher, Director Department of Economic Security Department of Commerce Mr. Rex Critchfield, LTC Chair and Assistant Mr. Jerry Ewing, Assistant Deputy Director Department Director, DES Division of Aging & Adult Services of Commerce 1789 W. Jefferson, 2nd Flr., SE, Site Code 001A 1700 W. Washington, Executive Tower, Suite 600 Phoenix, AZ 85007 Phoenix, AZ 85007 ( 602) 542- 6572, Fax ( 602) 364- 0743 ( 602) 771- 1176 or ( 602) 771- 1100 ( main receptionist) TWareing@ azdes. gov JanL@ azcommerce. com RCritchfield@ azdes. gov JerryE@ azcommerce. com Ms. Susan Gerard, Director Ms. Mary Lynn Kasunic Department of Health Services President & CEO/ Area Agency Director Ms. Mary Wiley, LTC Vice Chair and Assistant Area Agency on Aging, Region One, Inc. Director, DHS Division of Assurance and Licensure 1366 East Thomas Road, Suite 108 150 N. 18th Avenue, Suite 510 Phoenix, Arizona 85014 Phoenix, AZ 85007 ( 602) 264- 2255, Fax ( 602) 230- 9132 ( 602) 364- 3064, Fax ( 602) 364- 4808 kasunic@ msn. com Gerards@ azdhs. gov Wileym@ azdhs. gov The Honorable Carolyn S. Allen Ms. Greta Mang, Elder Rights Specialist Arizona State Senate DES Division of Aging and Adult Services 1700 W. Washington, Room 303 1789 W. Jefferson, Site Code 950A Phoenix, AZ 85007 Phoenix, AZ 85007 ( 602) 926- 4480, Fax ( 602) 417- 3155 ( 602) 542- 6440, Fax ( 602) 542- 6575 callen@ azleg. gov gmang@ azdes. gov The Honorable Meg Burton Cahill Mr. Anthony D. Rodgers, Director Arizona State Senate Arizona Health Care Cost Containment System 1700 West Washington Mr. Alan Schafer, ALTCS Manager, OMC Phoenix, AZ 85007 701 East Jefferson MD 6100 ( 602) 926- 4124, Fax ( 602) 417- 3017 Phoenix, AZ 85034 mburtoncahill@ azleg. gov ( 602) 417- 4614 Anthony. Rodgers@ azahcccs. gov Alan. Schafer@ azahcccs. gov The Honorable Bob Stump Mr. Franc Kahn, Executive Director Arizona House of Representatives Governor’s Council on Developmental Disabilities 1700 West Washington, Room 344 3839 North Third St, Suite 306, Site Code 074Z Phoenix, AZ 85007 Phoenix, AZ 85012 ( 602) 926- 5413, Fax 417- 3109 ( 602) 277- 4986, FAX ( 602) 277- 4454 bstump@ azleg. gov fkahn@ azdes. gov The Honorable Barbara McGuire Ms. Melanie Starns, Executive Director Arizona House of Representatives Governor’s Advisory Council on Aging 1700 W. Washington 1700 W. Washington St., Suite 240 Phoenix, AZ 85007 Phoenix, AZ 85007 ( 602) 926- 3012, Fax ( 602) 417- 3123 ( 602) 542- 4710 bmcguire@ azleg. gov mstarns@ az. gov Ms. Jill Harrison, Director Ms. Christina Urias, Director Area Agency on Aging, Region IV Department of Insurance Western AZ Council of Governments ( WACOG) Erin Klug, Special Assistant to the Director 224 S. 3rd Avenue 2910 N. 44th Street, Ste. 210 Yuma, Arizona 85364 Phoenix, AZ 85018- 7256 ( 928) 782- 1886, Fax ( 928) 329- 4248 ( 602) 364- 2186 Jillh@ wacog. com curias@ azinsurance. gov jharrisonwacog@ yahoo. com eklug@ azinsurance. gov mbutterfield@ azinsurance. gov 11/ 01/ 07/ pat
APPENDIX B
INTERAGENCY COUNCIL ON LONG- TERM CARE MEETING MINUTES
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Interagency Council on Long Term Care ( IACLTC)
Planning Meeting Minutes
January 3, 2007
Committee Chair Rex Critchfield called the meeting to order at 1: 40 p. m. Quorum was established. Rex announced Bob York, Assistant Director for the DES Division of Aging and Adult Services, had tendered his resignation. Rex was assuming the Acting Assistant Director’s position.
Rex welcomed everyone and asked for introductions. Council members present were Rex Critchfield, Mary Wiley, Kathleen Heard, Karen Duffy, Marian Lupu, Robert Nixon, Alan Schafer, Jami Snyder, Sue Gerard and Melanie Starns.
Public in attendance were Leona Goldfarb, Angela Arens, Kathleen Pagels, Dick White, Karla Avery, Kim Simmons, Robin Jordan, Lynn Larson, Allie Masters, Randy Scott and Pat Talcott.
Chair Rex Critchfield began the meeting with discussion of AZ Links Project. He stated that the morning’s Steering Committee had decided upon a regional collaborative approach where multiple agencies will work together to assist individuals and families through the long term care system. The AZ Links Project Manager will assist agencies in Maricopa and Mohave counties to formulate regional collaborations. Rex stated there is nothing for the Council to approve today and there would be more to share at the next meeting in March.
Vice- Chair Mary Wiley provided the purpose of today’s meeting along with the background of the Council, a review of the Council’s authorizing legislation, and a review of the Council’s vision, mission, and purpose statement.
Vice- Chair Mary Wiley summarized the background of the Council’s beginnings from 6- 7 years ago, which grew from a grievous episode in a nursing home and the death of a woman from a severe sunburn in a nursing home. Sue Gerard brought numerous individuals together to determine what could be done with the long- term care system, including legislation, and thus the IACLTC came into being. Vice- Chair Mary Wiley reviewed the seven legislative intents for the Council, its Vision, Mission Statement, and Purpose.
Mary stated the 7 legislative points:
1.
Ensures the dignity of consumers of long- term care services.
2.
Is designed to meet the individual needs of consumers.
3.
Provides services and programs that are of the highest quality.
4.
Promotes consumer self- determination by providing an opportunity for consumer choice and input.
5.
Enhances appropriate alternatives to institutional care such as home and community based long- term care services.
1
6.
Integrates various funding sources to provide affordable services at the highest quality.
7.
Coordinates applicable state and federal mandates that relate to long- term care services.
Mary proceeded to read the Council Vision Statement, which the Council changed to reflect the changing of “ mental” health to “ behavioral” health.
The Council Mission Statement was changed to add, “ this entity was designed to be a high level dialog vehicle for state policy makers to ensure coordination and to prevent duplication of resources”.
Rex stated the Council has two standing sub- committees, AZ Links Committee and the Direct Workforce Committee, which report to the Council and they are important when looking at planning activities for the year. The three committees spoke about their future plans and matched their plans to the Council’s seven legislative intents.
The Council, with public participation, identified initiatives for 2007 that will address each of the Council’s seven legislative intents by its two standing committees, by the State Committee for the Reduction of Pressure Ulcers and Restraints ( SCRPUR), and then initiatives for each of the member agencies.
1.
Ensures the dignity of consumers of long- term services.
Committee Plans
-
Direct Care Worker ( DCW) delivery of standardized curriculum
-
Statewide Coalition on Restraints and Pressure Ulcer Reduction ( SCRPUR) activities
2.
Is designed to meet the individual needs of consumers.
Committee Plans
-
AZ Links website
-
AZ Links Uniform Assessment Instrument ( UAI)
-
SCRPUR activities
Agency Activities
-
Long Term Care Insurance ( AHCCCS)
-
New Ombudsman training – ( DAAS- DES)
-
Dental coverage - GCDD
-
Falls prevention initiative – GACA
Gap Areas
-
How to better give people information/ respond
-
How to better integrate Adult Protective Services into the LTC system
2
3.
Provides services and programs that are of the highest quality
Committee Plans
-
AZ Links website
-
DCW delivery of standardized curriculum
-
SCRPUR activities
Agency Activities
-
Department of Insurance information on liability insurers
-
New Ombudsman training ( DAAS- DES)
-
DDD senior- focused unit
-
Consumer to consumer quality evaluation of services ( DDD)
-
Better education of physician ( UofA)
Gap Areas
-
Education of healthcare professionals
-
Nutrition & hydration of LTC recipients
4.
Promotes consumer self- determination by providing an opportunity for consumer choice and input.
Committee Plans
-
AZ Links website
-
AZ Links outreach and education
-
SCRPUR activities
Agency Activities
-
Education practioners re: disabled workers ( AHCCCS)
-
Consumer directed care ( AHCCCS, EPD)
-
Spouses as paid caregiver ( AHCCS)
-
Transitional services – 1 time only ( AHCCS)
-
Putting information on nursing home and assisted living home performance on web
-
Consumer cooperatives ( DDD)
-
Mature Workforce Initiative ( GACA)
Gap Areas
-
Impact of “ Choices” on Home & Community Based Services
3
5.
Enhances appropriate alternatives to institutional care such as home and community based long- term care services.
Committee Plans
-
AZ Links website
-
AZ Links outreach and education
-
DCW delivery of standardized curriculum
-
DCW staff to coordinate and explore incentives (“ operationalizing curriculum”)
-
SCRPUR activities
Gap Areas
-
Lifespan respite care federal legislation, need a statewide coalition for information and coordination.
6.
Integrates various funding sources to provide affordable services at the highest quality.
Committee Plans
-
DCW exploring/ coordinating incentives, resources, and more affordable services.
Gap Areas
-
Utilizing retired physicians and other health care workers, i. e., dentists.
7.
Coordinates applicable state and federal mandates that relate to long- term care services.
Committee Plans
-
AZ Links regional collaborations
-
AZ Links UAI
-
DCW – hiring jointly funded position
-
SCRPUR activities
Agency Activities
-
Aging 2020 Plan
Gap Areas
-
Older Americans’ Act Caregiver language – caregivers of adult children
Discussion was exchanged that the Council needed more legislative and agency director participation. This topic will be an agenda item at a future meeting.
It was agreed the Council would meet next month on February 7th. The meeting was adjourned at 3: 55 p. m.
4
1
Interagency Council on Long Term Care ( IACLTC)
Meeting Minutes
February 7, 2007
Committee Chair Rex Critchfield called the meeting to order at 1: 36 p. m. Quorum was established.
A.
Welcome and Introductions
Committee Members Present: Mary Wiley, Kathleen Heard, Marian Lupu, Melanie Starns, Uta Brotherton, Jami Snyder, Robert Nixon,
Public in Attendance: Kathleen Pagels, Angela Arens, Lynn Larson, Robin Jordan, Dick White, Karla Averill, Kim Simmons, Robin Coulon and Pat Talcott.
B.
Approval of Minutes
Meeting minutes from January 3, 2007 were approved as submitted.
C.
AZ Links Project Update
Robin Jordan stated there were two meetings scheduled for the regional collaboratives on February 9th for Mohave County and February 13th for Maricopa County. Work is moving forward on the IT Charter Agreement with AHCCCS and a meeting was held with DES IT to start building the content for the website.
D.
Direct Care Work Committee Update
Jami Snyder stated they are working on the first round of training here in Maricopa County on the Disability Module. Many providers are interested in having their employees take the training. Lynn Larson is contacting Ted Rausch at Pima College regarding the manuals. Curriculum for Pima College could be approved at the College Committee’s March meeting. Jami stated they are working with the local Area Agency to evaluate the training programs.
E. Review of the Executive Order 2007- 01 on Ensuring Quality In Long- Term Care Melanie Starns distributed a copy of the executive order issued January 2006 by the Governor. The purpose of this order is to focus on ensuring quality in long- term care through strategies in a 3- year Plan. Item # 11 of the Executive Order asked the IACLTC to recommend a Bill of Rights for consumers of home and community- based long term care services by July 2009. Chair Rex Critchfield called for a motion to undertake this request. Melanie Starns made the motion, Mary Wiley seconded the motion. There was no discussion and everyone was in agreement. This issue will be brought to a future meeting. Many issues were brought up regarding the executive order, such as licensing issues, discharging plan/ basic services, quality of services monitoring, surveys, complaint driven system, incentives for nursing homes with help from the council, toolkits through AZ Links, partners, colleges, libraries, faith based organizations, area agencies and the Ombudsman Program. Mary Wiley, DHS, stated that facility surveys are being redesigned for Internet use and she would bring copies to group for testing in May.
2
Interagency Council on Long Term Care ( IACLTC)
Meeting Minutes
February 7, 2007
Page 2
F. Follow- up to January’s Planning Session/ Review and Prioritization of Planned Activities/ Review and Prioritization of Gaps for presentations and discussion at future meetings Chair Rex Critchfield asked everyone to prioritize agency activities for future presentations to and discussions by council. The activities were prioritized as the following:
1.
Dental Coverage
2.
Consumer Direct Care
Dept. of Insurance Information on Liability Insurers
3.
Long- term Care Insurance
Consumer Cooperatives
Falls Prevention Initiative
4. New Ombudsman Training ( DAAS- DES)
DDD senior- focused unit
Spouse as paid caregiver ( AHCCCS)
Aging 2020 Plan
5. Consumer to consumer quality evaluation of services ( DDD)
Better education of physician ( UofA)
Transitional Services – 1time only ( AHCCCS)
Putting information on nursing home and assisted home performance on web ( EO, DHS)
Mature Workforce Initiative ( GACA)
The Gaps were prioritized as following:
1.
Integrate APS with Long- Term Care System, central registry, investigation of facilities and AG central registry to give better information and response.
Older American Act Caregiver language- caregivers of adult children. Coordinating OAA regulations with state appropriation. Still a gap – DD adult children with parents caring for them.
2.
Education of Healthcare Professionals
3.
Nutrition & Hydration of LTC recipients – DHS, CMS, Feeding Assistance Program
4.
Utilizing retired physicians. 3
Interagency Council on Long Term Care ( IACLTC)
Meeting Minutes
February 7, 2007
Page 3
These topics will be slated for future meetings.
G.
Member Announcements
Melanie gave an update on the 7 Senior Action Days, which will consist of a legislative luncheon and a public forum where the State Plan on Aging will be presented.
Chair Rex Critchfield stated the “ draft” Plan on Aging was currently being reviewed by Deputy Director Nelba Chavez and will eventually be posted on the Division of Aging and Adult Services website. The State Plan was very comprehensive.
Chair Rex Critchfield stated the next meeting is scheduled for Wednesday, March 7, 2007. Many stated they would be unable to attend on this date so March 14th was selected for the next meeting. Rex stated everyone would be contacted by e- mail to find out if there would be a quorum for March 14th.
H.
Call for Agenda Items
No additional agenda items were identified.
I.
Call to the Public
Kathleen Pagels stated her thanks to the Governor Napolitano for her leadership and the Executive Order. She further reviewed for the Council the concerns that she and the provider community had with the interpretation of the Executive Order.
J. Adjournment
With no other items, Chair Rex Critchfield adjourned the meeting at 3: 27 p. m. 1
Governor’s Interagency Council on Long- Term Care Council Minutes April 4, 2006
Council Members Present:
Rex Critchfield, Chairperson
Mary Wiley, Vice- Chairperson
Robert Nixon
Jami Snyder
Christina Urias
Alan Schafer
Council Member Absent:
Kathleen Heard
Marian Lupu
Melanie Starns
Uta Brotherton
Senator Carolyn Allen
Representative Bob Stump
Staff Present:
Robin Jordan
Lynn Larson
Pat Talcott
Jutta Ulrich
Guests Present:
Erin Klug
Dick White
Kim Simmons
Call to Order
Call to Order: The meeting was called to order at 1: 08 p. m. by Rex Critchfield, Council Chairperson.
Introductions
Introductions: All individuals who were in attendance introduced themselves.
It was noted a quorum of the council members was present for the meeting.
Minutes Approved
Approval of the February 7, 2007 Meeting Minutes: The members of the Council reviewed and approved the minutes.
The minutes were approved without objection.
AZ Links Project Update
AZ Links Project: Rex Critchfield asked Robin Jordan to present this report. Ms. Jordan reported on the two subcommittees of the Project’s Steering Committee. The Customer Assistance subcommittee is working on the development of a training manual to use for Project partners across the state, which would contain a core set of information on the long term care system. The Uniform Assessment Instrument subcommittee is working on a common assessment form for use by all Project partners.
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Governor’s Interagency Council on Long- Term Care April 4, 2006 meeting minutes
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Governor’s Interagency Council on Long- Term Care
April 4, 2006 meeting minutes
2
Ms. Jordan then spoke about the two regional collaboratives that have begun
meeting. The Mohave County Collaborative is working on a common referral
form, an MOU/ agreement to be signed by all partners, and a client screening
tool. The Maricopa County Collaborative is also working on an
MOU/ agreement for all partners as well as cross- training needs for all
partners.
Project staff are working with DES IT staff to establish a static web page for
the project. The estimated date for the web page to go live is 5/ 1.
Direct Care Workforce Committee Report
Direct Care Workforce Committee: Jami Snyder stated that the Core Curriculum Committee has been meeting. The Committee is considering the
best use of the funding provided through the DES Division of Aging & Adult
Services ( DAAS) to continue to promote the curriculum. One train- the- trainer
course has been conducted. A second session is planned and has approximately
37 individuals signed up to attend. The Region One Area Agency on Aging is
working on the evaluation portion of the project. Jutta Ulrich was introduced
as the new DAAS staff assigned to the Direct Care Workforce issue. Jami also
mentioned that Phoenix College has indicated that they will no longer be able
to provide the coordination of the curriculum for college credits due to
the decrease in the Full Time Student Equivalent funds they receive for each
student. Several members of the Core Curriculum and Expansion
Committee will be meeting with Rio Salado College to coordinate the delivery
of the curriculum for college credits.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: Mary Wiley on behalf of Melanie Starns that meetings have been scheduled for the state agencies referenced in the Executive Order. Activities in progress to meet the Executive Order include: a 2007 Reducing Pressure Ulcers Summit on 5/ 23; a
2007 Reducing Restraints Summit on 6/ 27; the Department of Health Services
( DHS) is revising their web site with nursing home and assisted living facility
information to immediately reflect any change in the home or facility score
based on a visitation or inspection; a Took Kit is being worked on by GACA;
DHS and AHCCCS will be meeting to find a way not to duplicate surveys of
facilities; and the IACLTC will be developing a Patient’s Bill of Rights by
2009.
Dental Coverage – Agency Activity
Dental Coverage: Jami Snyder stated that the Governor’s Council on Developmental Disabilities ( GCDD) had identified dental coverage as a number
one need as part of their planning process for their 5- Year Plan. They had put
together a workgroup on this issue. Alan Schafer reported that this year,
AHCCCS proposed a budget issue that became part of the Governor’s budget
for capped dental coverage for aging, physically disabled and developmentally ___________________________________________
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April 4, 2006 meeting minutes
3
disabled long- term care eligible individuals, up to $ 1,000 per person. S. B. 1488 limited coverage to the aging and physically disabled long- term care eligible. While optimism is not high on funding for this issue, the 68% match available to AHCCCS for such a program is appealing.
Department of Insurance Information on Liability Insurers – Agency Activity
Director of the Department of Insurance ( DoI), Christina Urias, gave a short presentation. The Nursing Home liability market is experiencing problems nationwide and insurers in Arizona are finding it particular difficult. DoI conducts marketing surveys. They found that of 184 licensed companies responding to their survey, only 3 were writing new business. The average claim against nursing homes has risen from $ 72,000 in 1993 to $ 176,000 in 2004 – a 144% increase in 11 years. Between 1996 and 2000, 15% of all claims exceeded $ 250,000 per claim. Carriers are aware of the severity of these claims, making it difficult to find re- insurers. This forces some nursing homes to turn to the non- admitted market, which is not subject to the same oversight as the admitted insurers. DoI just sent out their 2007 survey and the preliminary returns are indicating a similar situation.
A Report on Arizona Health Insurers was issued in May of 2006. It listed the top 25 insurers doing business in Arizona. It further disclosed that about 50% of the time, insurers will overturn their original decision on payment of claims if it is appealed.
Christina mentioned a New York Times article that was a scathing review of Long Term Care Insurance. One of its main criticisms was that, since it was a new type policy, many insurers originally set their premiums too low and policyholders are now experiencing 35% and 25% yearly increases. She reminded the Council that DoI can approve or disapprove rates on individual Long Term Care policies. However, only 15 complaints had been received by DoI in 2005 and 8 complaints in 2006 about Long Term Care policies.
Member Announcements
Jami Snyder – Announced that she was leaving the GCDD as their Executive Director and was taking a position with DHS.
Alan Schafer – AHCCCS’ contract to develop a consumer directed care model was moving forward and was basically on schedule, as was another initiative to pay spouses as caregivers up to 40 hours per week, another initiative moving into place is to provide funding for transition services to move from a nursing home back into the person’s home, and they have received a half- million dollar grant to assist persons with a disability obtain employment to move off Medicaid.
Call for Agenda Items
Rex suggested that for the next meeting, the Council receive presentations on the Falls Prevention Initiative ( an Agency Activity) and on DD Adult Children with Parents Caring for Them ( a Gap).
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Governor’s Interagency Council on Long- Term Care
April 4, 2006 meeting minutes
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The next meeting will be July 11 – not July 4th, the traditional meeting date because it is the first Wednesday in July. Notification will be sent to members to determine availability.
Call to the Public
Dick White – The National Life Span Respite Care bill has made it to the negotiation stage at the federal level. S. B. 1317, the state level counterpart, is doing well and has passed out of the Appropriations Committee by a unanimous vote. Dick also mentioned that there are ongoing discussions with DES to integrate or coordinate a statewide Caregivers Coalition with a statewide Respite Care Coalition.
Kim Simmons – Asked Director Urias’ whether the liability insurers for DDD group homes were the same insurers for nursing home. Director Urias responded in the affirmative.
Adjournment
The Chairperson adjourned the meeting at 3: 02 p. m.
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Interagency Council on Long- Term Care
July 11, 2007 meeting minutes
1
Interagency Council on Long- Term Care Council Minutes July 11, 2007
Council Members Present:
Rex Critchfield, Chairperson Mary Wiley, Vice- Chairperson Uta Brotherton
Alan Schafer
Erin Klug Robert Nixon
Cynthia Gafford
Council Member Absent:
Kathleen Heard
Melanie Starns
Senator Carolyn Allen Representative Bob Stump
Staff Present:
Lynn Larson Pat Talcott
Jutta Ulrich
Greta Mang
Guests Present:
Kim Simmons
Kathleen Pagels Genny Rose Karen Barno
Call to Order
Call to Order: The meeting was called to order at 1: 10 p. m. by Rex Critchfield, Council Chairperson.
Introductions
Introductions: All individuals who were in attendance introduced themselves.
It was noted a quorum of the council members was present for the meeting.
Minutes Approved
Approval of the April 4, 2007 Meeting Minutes: The members of the Council reviewed and approved the minutes. The minutes were approved without objection.
AZ Links Project Update
AZ Links Project: See attached report.
Direct Care Workforce Committee Report
Direct Care Workforce Committee: Jutta Ulrich reported on the progress of the project and the recommendations from the Core Curriculum and Expansion Committee’s strategic planning meeting, which included a direct care workforce training, parameters of the training program including tiers of certification, explore delivery methods, curriculum pilot in a rural area, ___________________________________________
Interagency Council on Long- Term Care
July 11, 2007 meeting minutes
2
continued training activities and evaluation in Maricopa and Pima counties, and subcommittees to implement the recommendations. The committee also advised the IACLTC that a public policy plan is needed to address the larger issues surrounding the direct care workforce in Arizona. Jutta advised that the project’s planned activities for FY2008 include expansion of the curriculum into Pinal- Gila region, continued training and evaluation in Maricopa and Pima counties, and the development of a ‘ hybrid” web- based course.
The Council asked the committee to come back to the next Council meeting with an agreed upon name for the committee, a membership list, and a work plan.
Alan Schafer agreed to become the new committee chair.
Uta Brotherton recommended that the committee check out collaboration possibilities with the Department of Commerce’s Apprenticeship Program.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: No report on this activity.
Ombudsman Training
Ombudsman Training: Bob Nixon advised there would be new Ombudsman training through out the state to all volunteers which would lead to certification and everyone would be provided with an updated manual. Also at their request, this training would included the Native Americans tribes.
State Plan on Aging
State Plan on Aging. Lynn Larson provided a handout on the State Plan Goals and Objectives and reported the State Plan on Aging was approved by the Governor’s Advisory Council on Aging. The next steps would be approval by DES management and the Governor.
Member Announcements
Member Announcements. Rex announced that the Legislature had appropriated $ 500,000 in state funds to the DES Division of Aging and Adult Services for the development of a statewide respite coalition and for the provision of respite care services.
Erin Klug advised the long- term care insurance brochure provided to the Council a few meetings back by the Department of Insurance is now on their website and to contact her if there was any questions or concerns regarding long term care insurance.
Alan Schafer reported on the state appropriation to AHCCCS of $ 1,000 per person for non- emergency Adult Dental Care, which does not include dentures. Alan stated a policy is being drafted to be provided to AHCCCS management ___________________________________________
Interagency Council on Long- Term Care
July 11, 2007 meeting minutes
3
regarding payment to caregiver spouses who provide healthcare 7 days a week. Also in the works is a Community Reintegration Program to assist someone moving from a nursing home back into their own home, which would provide $ 2,000 per member within a 5 year period for utility deposits and basic furnishings.
Alan stated that AHCCCS will launch a Consumer Directed Care program targeted to start October 1, 2007. This program will allow the consumer to delegate service tasks. Implementation issues are still being worked through, such as fiscal agent unemployment insurance.
AHCCCS has received a $ 500,000 Medicaid grant in collaboration with Medicaid Freedom to initiate an Arizona Health and Disability Partnership program to assist members who are working or wanting to go back to work. It is designed to better link the independent living systems with the employment network. Derek Johnson is Project Manager of the 3- year grant.
Call for Agenda Items
Agenda Items. Rex advised at the next IACLTC meeting on September 5, 2007 the Council will receive a draft of the Annual Report so it could be approved at the October 3, 2007 meeting instead of waiting until the November 7, 2007 meeting for approval.
Call to the Public
No comments.
Adjournment
The Chairperson adjourned the meeting at 3: 00 p. m.
AZ Links Update JULY 1, 2007
Regional Collaboratives
Cross Training Materials have been developed by the CAC Committee.
􀂃
Finalization of those materials will be determined at the July 18th Meeting.
􀂃
A contractor will compile all materials into an instructional manual and desk reference.
Cross Training –
􀂃
Mohave Regional Network have developed training outlines and set three training days – 2 in September and one in October. Staff participating in the cross trainings have also been identified.
􀂃
Maricopa Regional Network has determined their regional training format and will
determine dates for those cross trainings at their July meeting. They expect to
hold the trainings in October/ November timeframe.
Website Development –
􀂃
AZ Links website is expected to go live the last week in July. It is being developed by the PIO office. It will be located on the DAAS website and will also have a separate URL: www. azlinks. gov.
􀂃
This site will have links to various websites arranged by topic. However it will not be interactive. Topics include: Aging and Other Resources; Caregiver Resources; Employment; Financial Help; Fitness, Health & Nutrition; Fraud, Scams & Legal Matters; Housing Options; Independent Living Supports; Insurance, Medicare & Other Benefits; Long Term Care Choices; Personal Safety; Socialization/ Recreation; Transportation; Tribal Resources; Volunteering.
􀂃
Website Continuing Development – Interactivity will be built as this website is developed to include the Screening Tool and a Common Intake.
Background: Following the formal agreement between AHCCCS and DAAS, AHCCCS has appointed Linda Schwank to work with us to develop the website connection with AHCCCS.
􀂃
Linda Schwank is currently developing a work plan to develop the functionality of the website and proposes to launch a Pilot with functionality.
Focus groups are being assembled to give feedback on both the Screening Tool and the Website once the website is launched.
􀂃
The Governor’s Council on Developmental Disabilities has identified persons with developmental disabilities, persons with physical disabilities in both Pilot regions.
􀂃
The Area Agency on Aging in Region One and Region 4 are providing participants representing the aging community.
Screening Tool – is currently being tested for validity in Mohave and Maricopa Counties.
􀂃
It has been installed on the WACOG AAA Region 4 website ( English and Spanish translations). 􀂃
Installation of the Screening Tool on the AAA, Region One website is expected any day.
Background: The Screening Tool is designed to be a self- help tool. Following data entry, it is sent to an Information Specialist who then calls the person and assists in locating the services they are requesting, or referring to the most appropriate agency.
Common Intake Matrix – A Common Intake is being developed by the Uniform Assessment Instrument committee. Kris Bursac has incorporated committee recommendations, and will present a Final Draft at the UAI Meeting on July 18th . If approved, it will be forwarded for Steering Committee approval on August 1.
Triggers – Identifying the elements that determine where the consumer should be directed.
􀂃
Expected Completion: August, 2007.
Background: The UAI committee members have submitted the triggers and are now creating a decision tree to determine which of their respective agencies are the most appropriate to handle the specific individual’s needs. This will guide IT development, to provide the information on agencies that will most likely provide the services needed.
Inventory of Services – The Customer Assistance Committee has agreed on a list of 40 service categories and 143 services available from the partner agencies, state and federal programs. This inventory will help I & R staff in directing consumers to the correct agency. The value of this Inventory:
1)
Helps staff from other agencies know what each agency provides;
2)
Provides easy location of services based on a category of services;
3)
Illustrates if there are gaps in services;
4)
Using AIRS taxonomy as well as other agreed upon service categories, facilitates search capabilities when a database is developed on the website.
Inventory of Sites – A complete list of locations ( 365) throughout the state has been compiled. Agencies include DES, AHCCCS, DDD, AAA offices. Other service locations include Benefits Check Up, AZ Secure, and SHIP sites.
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Interagency Council on Long- Term Care
September 5, 2007 meeting minutes
1
Interagency Council on Long- Term Care
Council Minutes
September 5, 2007
Council Members Present: Rex Critchfield, Chairperson
Mary Wiley, Vice- Chairperson
Alan Schafer
Erin Klug
Greta Mang
Melanie Starns
Franc Kahn
Council Member Absent: Jan Lesher/ Uta Brotherton
Senator Carolyn Allen
Representative Bob Stump
Staff Present: Lynn Larson
Pat Talcott
Robin Jordan
Allie Masters
Guests Present: Kim Simmons
John Linda
Fran Atkinson
Jana Bertucci
Andy Weiler
Call to Order Call to Order: The meeting was called to order at 1: 33 p. m. by Rex Critchfield, Council Chairperson.
Introductions Introductions: All individuals who were in attendance introduced themselves. It was noted a quorum of the council members was present for the meeting.
Minutes Approved Approval of the July 11, 2007 Meeting Minutes: The members of the Council reviewed the minutes and Melanie Starns asked for removal of “ Governor’s” before Interagency Council on Long Term Care title. Alan Schafer moved to approve the minutes. Greta Mang seconded the motion and the minutes were approved without objection.
Update on Council Membership
Update on Council Membership: Rex Critchfield, Council Chairperson, stated that Senator Meg Cahill would be the new representative for the Senate. Area Agency on Aging urban and rural representatives have been accepted and the Council is awaiting their signed Oaths of Office. Greta Mang, new supervisor over the Ombudsman Program, replaces Bob Nixon the Council. The Council roster will be updated to reflect the changes. ___________________________________________
Interagency Council on Long- Term Care
September 5, 2007 meeting minutes
2
AZ Links Project Update
AZ Links Project: Allie Masters reported the launching of the website, through DES and stated the site provides a plethora of levels of information for aging, developmental disabled, and disabled. She stated the website is a work in progress and welcomes suggestions. A project manager from AHCCCS has been assigned to help develop the AZ Links web application. Regional networks have been established in Mohave and Maricopa counties, bringing together Area Agencies on Aging, the Division of Developmental Disabilities, AHCCCS, and the independent living agency. Staff cross trainings will occur from September through December. Chairperson Critchfield stated there had been coordination with the Governor’s Council on DD to have focus groups evaluate the maneuverability, accessibility, assessments, and improvements to the AZ Links website.
Direct Care Workforce Committee Update
Direct Care Workforce Committee: Alan Schafer stated they have been meeting through the first part of the year establishing 3 sub committees on curriculum, training, implementation, and marketing aspects. Chairperson Critchfield clarified that the Governor’s Advisory Council on Aging ( GACA) is forming a caregiver coalition group focused on the unpaid caregiver. Lynn Larson further clarified that the DAAS is developing a Lifespan Respite Care Program, through a $ 500,000 state appropriation, which will assist individuals who do not qualify for current respite programs. Criteria are in development for those who will be serviced.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: Melanie Starns reported that half of the objectives of a work plan to accomplish the Executive Order have been accomplished. Accomplishments have included a Conference on the Use of Restraints by ADHS ( 250 attendance) and ADHS has on- line survey results for nursing homes and childcare which are more user friendly. A press release about a Tool Kit for use in facilities was issued last week and is a good resource for the ombudsmen. Next year’s work will include a Consumer Bill of Rights for Home Based Care.
Falls Prevention Initiative
Falls Prevention Initiative: Andrew Weiler stated that he is chairing a subcommittee of the GACA which is developing a track on Falls Prevention for the Governor’s Conference on Aging for May 2008 in Tucson. Mr Weiler stated that he was also working to develop a survey tool to detect the likelihood of a person falling. Chairperson Critchfield suggested that APS workers would benefit from having such a survey to administer to their clients. Free standing tools are available now. Co- chair Mary Wiley stated cards on the signs of abuse are currently being given to paramedics.
Draft Annual Report
Draft Annual Report. Chair Critchfield stated that the Council’s Annual Report is due to the Governor and the Legislature on the 15th of November. This year’s draft Report includes a section on results of the Council’s strategic ___________________________________________
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September 5, 2007 meeting minutes
3
planning session in January, reports on the three committees, and uses the seven public meetings that DAAS used around the state to collect input on their State Plan on Aging. Comments on the draft Annual Report are needed within 2 weeks. Changes will be incorporated and sent back out to the Council in a week. Next meeting will be on Wednesday, October 17, 2007 @ 2: 30 p. m.
Member Announcements
Alan Schafer announced that dental services with a one time authorization for $ 1,000 through the ALTCS Program would now be available from October 1, 2007 through September 30, 2008. Also starting October 1st is a payment for up to 40 hours of in- home service in a 7 day period for caregiver spouses. Community Integration payments will be available for settling into one’s own home/ apt., to include furniture, utility deposits, etc. The $ 2,000 allowance is available every 5 years. The Self Directed Care project is delayed until April 2008.
Greta Mang reported that on October 18, 2007, an Ombudsman Quarterly Meeting will be held and include APS and the AG’s office. The meeting will have a legal theme. Greta, as the new Ombudsmen Program supervisor, will be making statewide visits, is in the process of planning a two day annual meeting, is working on the Nursing Home Resident Rights Brochure, and will be re- designing and updating current booklets and posters. Greta advised that October 7- 14 is Residents Rights Week.
Melanie Starns announced that the Governor will officially open the new Governor’s Office on Aging at 11: 00 a. m. on September 7, 2007. There will be an Open House and everyone is invited to attend.
Call for Agenda Items
None
Call to the Public
John Linda stated that although his office has moved, their e- mail and phone number have not changed.
Adjournment
The Chairperson adjourned the meeting at 2: 57 p. m.
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Interagency Council on Long- Term Care
October 17, 2007 meeting minutes
1
Interagency Council on Long- Term Care
Council Minutes
October 17 2007
Council Members Present: Rex Critchfield, Chairperson
Mary Lynn Kasunic
Lisa Wynn for Mary Wiley, Vice- Chairperson
Mary Butterfield for Erin Klug
Greta Mang
Melanie Starns
Franc Kahn
Council Member Absent: Mary Wiley, Vice- Chairperson
Alan Schafer
Jan Lesher/ Uta Brotherton
Senator Carolyn Allen
Representative Bob Stump
Senator Meg Burton Cahill
Representative Barbara McGuire
Jill Harrison
Staff Present: Jutta Ulrich
Pat Talcott
Allie Masters
Guests Present: Kim Simmons
Kathleen Pagels
Annette S. Quinata
Heidi Otis
Jana Bertucci
Judy Clinco
Call to Order Call to Order: The meeting was called to order at 2: 31 p. m. by Rex Critchfield, Council Chairperson.
Introductions Introductions: All individuals who were in attendance introduced themselves. Rex Critchfield, Council Chairperson, welcomed Mary Lynn Kasunic as a new member of the council and presented her with a certificate and oath of office.
Minutes Approved Approval of the September 5 , 2007 Meeting Minutes: The members of the Council reviewed the minutes and Melanie Starns asked for the following revisions: page 2 under Direct Care Workforce Committee, second line should be meeting not meetings and under Falls Prevention Initiative, first line should read as follows, Andrew Weiler stated that he is chairing a subcommittee of the GACA which is developing…. etc. Chairman Critchfield asked for approval as ___________________________________________
Interagency Council on Long- Term Care
October 17, 2007 meeting minutes
2
amended. Melanie Starns motioned for approval, Greta Mang seconded the motion and the minutes were approved as amended.
Update on Council Membership
Update on Council Membership: Rex Critchfield, Council Chairperson, stated the council roster was updated to reflect the changes in the council and available to everyone at this meeting..
AZ Links Project Update
AZ Links Project: Allie Masters reported eventually AZ Links will have its own database and server but for now the website is static. Through a “ real time” presentation Allie demonstrated the different methods of accessing information on the site and provided information by Google Analytics about how many hits the website has received, the amount of time each page is viewed and which pages were viewed the most from August 1, through October 15, 2007. Allie stated the Contact Us feature was being utilized and suggestions were made for an “ Exit Survey” button.
Direct Care Workforce Committee Update
Direct Care Workforce Committee: Jutta Ulrich provided the information for Alan Schafer, who was unable to attend the council meeting. Jutta reported a Programs Contractor meeting was held and 3 subcommittees are working on their plans and will report to the full committee in the spring. The three sub- committees are the Standards and Certification, Teaching and Delivery Methods and Public Education and Marketing.
Executive Order 2007- 01 on Ensuring Quality in Long Term Care Update
Ensuring Quality Care in Long Term Care: Melanie Starns stated there was nothing new to report.
Draft Annual Report
Annual Report. Chair Critchfield asked for a motion for the approval of the Annual IACLTC report which is due to the Governor and Legislature by November 15th. Mary Lynn Kasunic asked for revisions on page 3, Section IV. Meeting Dates, removal of November 6, 2007 and addition of today’s meeting date of October 17, 2007, and under Gap Areas, removal of apostrophe to Older Americans Act. Melanie Starns asked for a revision on page 9, third paragraph, first line, the removal of “ about” at the end of the line. Mary Lynn Kasunic made the motion to approve the report, Franc Kahn seconded the motion and the report was approved as amended.
Arizona Direct Care Worker Association
AZ Direct Care Worker Association: Judy Clinco, of the AZ Direct Care Worker Association through a PowerPoint Presentation and hand- out, shared the goals of the newly created organization based in Tucson, Arizona. It is a not for profit 501 ( C)( 3) and is a membership and advocacy organization that hopes to provide Public Education and Awareness, positive changes in the Public Perception of the Direct Care Worker and Membership Services for the Direct Care Workers. ___________________________________________
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October 17, 2007 meeting minutes
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Member Announcements
Member Announcements: Greta Mang announced the resignation of Bob Nixon, Ombudsman for DAAS on October 5, 2007 and stated a new ombudsman would be hired. Greta stated the quarterly gathering of Ombudsman and Volunteers, APS, and the Attorney General’s Office would be taking place tomorrow in Casa Grande. There would also be a quarterly meeting regarding health care coming up. Greta also informed everyone she had redesigned the Arizona Long Term Care Ombudsman brochure and passed around a limited copy for everyone to view. The brochures will be available in English and Spanish and are not yet in full production and only a few were printed for tomorrow’s gathering.
Call for Agenda Items
No agenda items were presented. Rex Critchfield announced the next IACLTC meeting would be on Wednesday, February 6, 2007 from 1: 30 to 3: 30 p. m.
Call to the Public
Kim Simmons stated DDD is in their 3rd year of Direct Support Recognition and asked agencies be contacted for any nominations. Kim stated Friday, November 9th is Direct Support Professional Day.
Adjournment
The Chairperson adjourned the meeting at 4: 10 p. m.